Endocrine Abstracts

Background: Gas-forming pyogenic liver abscess is an uncommon, life-threatening infection that is usually found in poorly-controlled diabetic patients. Here, we experienced a case of gas-forming pyogenic liver abscess in diabetes caused by Klebsiella pneumoniae.Clinical case: A 77-year-old man with 25-year history of diabetes was admitted due to fever for 2 days. On the physical examination, right upper quadrant tenderness of the abdomen was present. Ini...

Introduction: Evidence suggests that ionised calcium (iCa) and not total calcium is the physiologically relevant blood calcium component. Most blood gas (BG) analysers calculate iCa, but this is often ignored. We report our findings from a retrospective audit in medical in-patients and the potential benefit of this underused resource.Methods: A retrospective audit of admissions to two general medical/endocrine wards during January and February 2016. Data...

Methyl oxime–trimethylsilyl (MO-TMS) derivatisation with gas chromatography–mass spectrometric (GC-MS) analysis has been well established in the analysis of glucocorticoids and is still used in many laboratories for profiling endogenous steroids for clinical purposes. There appears to be a clinical need to extend the analysis to xenobiotic glucocorticoids, primarily to elucidate cases of patients presenting with adverse symptoms associated with glucocorticoid excess,...

Introduction: Gas chromatography tandem mass spectrometry (GC-MS/MS) quantitatively detects many steroids at one time in a single serum sample. Cushing’s syndrome (CS) caused by adrenal adenoma is often associated with decreased DHEAS, whereas low levels of aldosterone in ACTH dependent CS and also low levels of 18-oxocortisol were observed in ectopic CS. We aimed to evaluate steroid differences in various types of CS.Methods: In serum from patients...

Introduction: The diagnosis of Cushing’s syndrome (CS) can be challenging and there is no single gold standard diagnostic test. Endocrinologists rely on a combination of plasma cortisol (before and after dexamethasone), midnight salivary cortisol and urinary free cortisol (UFC) to make the diagnosis. Assessment of urinary corticosteroids and their metabolites, measured by gas chromatography–mass spectrometry (GC–MS), provide a comprehensive picture of corticoste...

Introduction: Steroid profiling by mass spectrometry approaches consists in the simultaneous measurement of several steroid molecules in a biological sample, allowing an optimal characterization of steroidogenesis alterations, particularly in the context of adrenal tumors. Twenty-four hours urine samples have the advantage of being non-invasive and of giving an integrated view of steroidogenesis. Urinary steroid profiling has thus been shown to be particularly useful in the di...

Introduction: Gas chromatography mass spectrometry (GC-MS) is the gold standard method for urinary steroid profiling. However, GC-MS requires chemical derivatisation, long run times, is labour intensive, expensive, and unsuitable for rapid multi-sample analysis, limiting its use in routine clinical practice. GC-MS urinary steroid metabolomics, the combination of steroid profiling and machine learning (Generalized Matrix Learning Vector Quantization) was shown to have superior ...

Introduction: Gas chromatography tandem mass spectrometry (GC-MS/MS) quantitatively detects a large number of steroids at one time in a single serum sample. Most studies of subclinical hypercortisolism in adrenal incidentalomas have focused on detection of a few steroids like cortisol, DHEA/S, androstenedione, testosterone. We used GC-MS/MS to quantify 91 steroids in patients with adrenal incidentalomas to search for the most reliable marker of subclinical hypercortisolism.</p...

Introduction. As for many minor metabolites of steroids, no authentic standard is commercially available for 18-OH-THA. This compound is the principal urinary metabolite of 18-hydroxycorticosterone, a putative intermediate in the synthesis of aldosterone and of diagnostic value in screening for hypermineralocorticoidism. Since de novo synthesis is time-consuming and expensive, we tested the possibility of using beta-cortol, which produces an ion at m/z 457 in common wit...

Corticosteroids are major contributors to normal blood pressure control and to hypertension. The diagnosis of 'primary aldosteronism' based on raised aldosterone: renin ratios is now common although demonstration of an adrenocortical tumour remains rare. Moreover, the relationship between aldosterone and renin or angiotensin II in essential hypertension is often disturbed, suggestive of altered control of aldosterone biosynthesis. Aldosterone is synthesised from 11-deoxycortic...