SST tube for cortisol and EDTA tube (on cold pack) for ACTH. Synacthen for INPATIENTS must be dispensed by the hospital pharmacy. Synacthen for OUTPATIENTS is brought to the collection centre by the Chemical Pathologist or Registrar performing the test.
BOOKING INFORMATION All non-urgent tests MUST be booked in advance. A copy of the SST patient information sheet should be provided to all outpatients at the time of booking. 1. OUTPATIENTS (Public and Private): contact Specimen Collection (3163 8732) or a Licensed Collection Centre. Testing is available by appointment between 8am and 9am at Mater Outpatients Sth Brisbane. Collectors to pre-arrange with Chemical Pathologist or Registrar (3163 8872 or 3163 8911). 2. INPATIENTS (Public): contact public Specimen Collection service. (Collectors are to accept bookings and place bookings on the whiteboard in the storeroom). The Synacthen must be prescribed for the patient and dispensed by the pharmacy. 3. INPATIENTS (Private): contact private Specimen Collection service. The Synacthen must be prescribed for the patient and dispensed by the pharmacy.
PRE-TEST PREPARATIONS: 1. Fasting is not required for this test. 2. Medications should be withheld on the morning of the test, unless the patient has been told otherwise by his/her doctor. The patient should bring them to the collection centre to take when the test is finished. 3. Note medications being taken.
TEST PROCEDURE: 1. At 0900 collect baseline specimens for cortisol and ACTH. 2. Administer 250 ug Synacthen (10 ug Synacthen per kg body weight in children less than 25 kg) intramuscularly, or intravenously if a medical officer is present. Record dose and time given. 3. 30 minutes post Synacthen, collect specimen for cortisol. 4. 60 minutes post Synacthen, collect specimen for cortisol.
Please record date and time of collection on each specimen.
GENERAL NOTES
Please Note: Item 66701 applies if the ACTH is not specifically requested by the requesting clinician and if the patient does not fail the SST. If the patient fails the SST or the requesting doctor specifically asks for an ACTH, then the ACTH is performed. When the ACTH is performed the item number changes to 66704. The public price above is for item 66701. Public price for item 66704 is $70.15.
Contact Phlebotomy Services to book this test.
Outpatient testing must have commenced by 9am.
APPLICATION: The standard Short Synacthen Test is indicated for: (1) The diagnosis of adrenal insufficiency (2) The differentiation of primary (adrenal – cortisol deficiency) and secondary (pituitary – ACTH deficiency) causes of adrenal insufficiency. Basal ACTH measurements are collected. (3) Congenital adrenal hyperplasia. 17OHP levels are collected during the procedure.
INTERPRETATION: Failure to respond indicates adrenal insufficiency. If basal ACTH is elevated, this suggests primary adrenal failure.
