Send frozen to referral laboratory weekly
Blood sample must reach the laboratory within 30 minutes (and preferably have been taken onto ice)
NOTE TIME WHEN SPECIMEN WAS TAKEN.
Centrifuge within 30 mins, using cold buckets.
Transfer plasma to a labelled plastic tube.
If visible haemolysis is present, discuss the suitability of the sample with the duty biochemist.
Store plasma immediately at -20oC
Adrenocorticotropic hormone (ACTH) is produced in the pituitary gland to stimulate secretion of cortisol by the adrenal glands. Normally, ACTH increases when cortisol is low and falls when cortisol is high. The concentration of ACTH varies greatly at different times of the day, with the highest amount at about 8 am and the lowest about midnight, therefore the sample will normally be collected first thing in the morning.
Secretion of ACTH may be increased by stress.
Some drugs and conditions can cause ACTH levels to rise, including amphetamines, insulin, levodopa, and metoclopramide.
Drugs that cause ACTH to fall include dexamethasone and other drugs that act like cortisol (including prednisone, hydrocortisone, prednisolone, and methylprednisolone), and megestrol acetate.
Ectopic tumours may secrete fragments or big ACTH which are biologically active but undetected by the assay.
Cross reactivity with synacthen is <= 1%
Ensure patient is not taking corticosteroids, synacthen and avoid undue stress. Please state time of collection. Lithium heparin interferes with the assay. Take blood into EDTA tubes and send to the lab immediately on ice.
To diagnose adrenal and pituitary diseases such as Cushing's syndrome, Cushing's disease, Addison's disease, adrenal tumors, and pituitary tumors; usually done as a diagnostic test once an abnormal cortisol level is detected.
Laboratory participates in the NEQAS scheme
The laboratories at Heartlands Hospital, Good Hope Hospital and Solihull Hospital form part of the services provided by University Hospitals Birmingham and are UKAS (United Kingdom Accreditation Service) accredited to the ISO 15189:2012 standard. For a list of accredited tests and other information please visit the UKAS website using the following link: https://www.ukas.com/find-an-organisation/
Tests not appearing on the UKAS Schedule of Accreditation currently remain outside of our scope of accreditation. However, these tests have been validated to the same high standard as accredited tests and are performed by the same trained and competent staff.
For further test information, please visit the test database: http://www.heftpathology.com/frontpage/test-database.html.
Protection of personal information - Laboratory Medicine comply with the Trust Data Protection policy and have procedures in place to allow the Directorate and its employees to comply with the Data Protection act 1998 and associated best practice and guidance.
For further information contact Louise Fallon, Quality Manager, 0121 424 1235