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Testa,b Source Ages,Conditions, etc Conventional Units Conversion Factor SI Units Comments
Adrenocorticotropic hormone (ACTH) stimulation test (cosyntropin test): 0.25 mg of synthetic ACTH1-24 (cosyntropin) is administered IV or IM, and serum cortisol is measured at 0, 30, and 60 min. Normal response: peak cortisol >20 μg/dL (>540 nmol/L). A dose of 1 μg of ACTH will give a similar response in the normal individual (see Chapter 9).
ACTH Plasma

<3 y

3-17 y

>18 y

Not established

9-57 ng/L

6-50 ng/L

0.222

2-12.7 pmol/L

1.3-11 pmol/L

Collect in silicone-coated EDTA-containing tubes. Keep iced. Avoid contact with glass during collection and separation. Process immediately. Separate and freeze plasma in plastic tube at –20°C.
Aldosterone

Serum (fasting)

>18 y

Upright 8:00-10:00 AM

Upright 4:00-6:00 PM

Supine 8:00-10:00 AM

Pediatric

1-12 mo

1-4 y

5-9 y

10-13 y

14-17 y

Premature Infants (31-35 wk)

Term Infants

<28 ng/dL

<21 ng/dL

3-16 ng/dL

2-70 ng/dL

2-37 ng/dL

<9 ng/dL

<21 ng/dL

<35 mgdL

<144 ng/dL

<217 ng/dL

27.7

<776 pmol/L

<582 pmol/L

83.1-443 pmol/L

55.4-1939 pmol/L

55.4-1025 pmol/L

<243 pmol/L

582 pmol/L

970 pmol/L

3989 pmol/L

6011 pmol/L

Levels in pregnant patients are three to four times higher.

Urine

Sodium diet (100-300 mmol/d)

Children:

 2-7 y

 8-11 y

 12-16 y

Adult

Post-fludrocortisone or intravenous saline infusion

 

 

≤5.7 μg/d

≤10.2 μg/d

≤15.6 μg/d

≤2.3-21 μg/d

≤5.0 μg/d

Collect 24-h specimen in 10 g boric acid to maintain pH ≤7.5. Refrigerate during collection.
Alkaline phosphatase, bone specific Serum

2-24 mo

6-9 y

10-13 y

 Males

 Females

14-17 y

 Males

 Females

Adult males

 18-29 y

 30-39 y

 40-49 y

 60-68 y

Adult females

 18-29 y

 30-39 y

 40-49 y

 50-76 y

25.4-124.0 μg/L

41-134.6 μg/L

 

43.8-177.4 μg/L

24.2-154.2 μg/L

 

13.7-128 μg/L

10.5-75.2 μg/L

 

8.4-29.3 μg/L

7.7-21.3 μg/L

7.0-18.3 μg/L

7.6-14.9 μg/L

 

4.7-17.8 μg/L

5.3-19.5 μg/L

5.0-18.8 μg/L

5.6-29 μg/L

IRMA; collect following an overnight fast; useful in Paget disease and osteoporosis; assay also known as Ostase; increased levels seen in states of high bone turnover (Paget disease, hyperthyroidism, osteoporosis).
Alpha subunit Serum

Men

Women

 Premenopausal

 Postmenopausal

Hypothyroid

Pregnant or hCG-producing tumor

≤0.6 ng/mL

≤1.5 ng/mL

0.9-3.3 ng/mL

≤3.7 ng/mL

1.8-360 ng/mL

RIA; used to assess gonadotropin hormone subunit secretion in pituitary adenomas.

3α-Androstanediol

glucuronide

Serum

Prepubertal children

Tanner Stages II-III

 Male

 Female

Adult

 Male

 Female

0.1-0.6 ng/mL

 

0.19-1.64 ng/mL

0.33-2.44 ng/mL

 

2.6-15 ng/mL

0.6-3.0 ng/mL

2.14

0.2-1.3 nmol/L

 

0.41-3.51 nmol/L

0.71-5.22 nmol/L

 

5.6-32.1 nmol/L

1.3-6.4 nmol/L

Freeze serum and store at –20°C.
Androstenedione Serum

Men

 18-30 y

 31-50 y

 51-60 y

Women

 Follicular

 Midcycle

 Luteal

 Postmenopausal

Children

 1-12 mo

 1-4 y

 5-9 y

 10-13 y

 14-17 y

 Premature infants (31-35 wk)

 Term Infants

Tanner II-III

 Male

 Female

Tanner IV-V

 Male

 Female

 

50-220 ng/dL

40-190 ng/dL

50-220 ng/dL

 

35-250 ng/dL

60-285 ng/dL

30-235 ng/dL

20-75 ng/dL

 

6-78 ng/dL

5-51 ng/dL

6-115 ng/dL

12-221 ng/dL

22-225 ng/dL

17-82 ng/dL

 

<290 ng/dL

 

17-82 ng/dL

43-180 ng/dL

 

57-150 ng/dL

7-68 ng/dL

3.49

 

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