Endocrine Abstracts

The duty biochemist at Barts Health noted a testosterone result of 17 nmol/l on a 20-year-old female, measured by Roche E170 electrochemiluminescence immunoassay. Laboratory policy is that all female testosterone results >2.5 nmol/l by immunoassay (upper reference limit 1.92 nmol/l) are checked by LCMS to exclude analytical interferences. The LCMS result on this sample was below the limit of quantification (<0.5 nmol/l).Clinical details were &#14...

Urine free cortisol (UFC) is analysed in 24 h urine collections in suspected Cushing’s syndrome, and provides an integrated measure of cortisol secretion over the whole day. The aim of this audit was to review how clinically useful UFC results were, and whether this analytical service was still justified. The current automated immunoassay with manual sample preparation was time-consuming, expensive (disproportionate quality control / external quality assessment (EQA) samp...

A 37-year-old woman, 30 weeks pregnant, presented with palpitations and abdominal cramps. Ultrasound demonstrated a supra-renal abnormality and MRI showed a 10 cm heterogeneous left adrenal mass. For five years she had experienced episodes of palpitations, shaking, sweating and chest tightness. She was investigated by a neurologist and diagnosed with temporal lobe epilepsy. During pregnancy the frequency of episodes increased. Lamotrigine was started, but at each dose increase...

Introduction: Phaeochromocytoma localisation is generally reliably achieved with modern imaging techniques, particularly in sporadic cases. Diagnostic doubt can arise due to the presence of bilateral adrenal abnormalities, particularly in patients with mutations in genes predisposing them to the phaeochromocytoma development. In such cases, surgical intervention is ideally limited to large or functional lesions due to the long-term consequences associated with hypoadrenalism. ...