Endocrine Abstracts

Introduction: The presence of heterophilic antibodies resulting in assay interference could lead to falsely high or low values in biochemical investigations. We present a case of a 5-year-old girl who had persistently high level of TSH despite Levothyroxine treatment.History: A five-year girl was found to have an elevated plasma TSH level (24.29 mU/L) with normal Free T4 (both measured using Abbott Alinity immunoassay) w...

Background: The 1 mg overnight dexamethasone suppression test (ONDST) is recommended for the differential diagnosis of Cushing’s syndrome and the investigation of adrenal incidentalomas. However, diagnostic performance of the test relies on accurate methods to quantitate cortisol in serum. Although the variable performance of serum cortisol immunoassays has been well-documented, little has been published on their performance following the ONDST.Aims...

Objective: To investigate performance of sex hormone binding globulin (SHBG) assays of different manufacturers and the effects of assay choice on calculated free testosterone (cFT).Methods: Anonymized serum samples of 113 men and 106 women were randomly selected from excess material from the routine clinical lab at the University Hospital of South Manchester. SHBG levels were measured using three different immunoassays (...

Background: Euthyroid hyperthyroxinaemia can present a diagnostic challenge. Abnormalities in the binding proteins of thyroid hormones can cause this discordant picture of thyroid function tests, with thyroxine binding globulin being the protein most commonly affected. Familial dysalbuminaemic hyperthyroxinaemia is a rarer cause, and is an autosomal dominant condition which can present with euthyroid hyperthyroxinaemia. This condition is associated with a mutation in albumin w...

Frequent measurement of blood glucose among hospitalized patients including those in critically ill areas is routinely practiced. Evidence suggests that tight glycaemic control among hospitalized patients reduced complications such as sepsis and has been shown to reduce length of stay. Most commercially available devices have not been assessed in critically ill patients, furthermore point of care (POC) glucose testing among paediatric populati...

Frequent measurement of blood glucose among hospitalized patients including those in critically ill areas is routinely practiced. Evidence suggests that tight glycaemic control among hospitalized patients reduced complications such as sepsis and has been shown to reduce length of stay. Most commercially available devices have not been assessed in critically ill patients, furthermore point of care (POC) glucose testing among paediatric populati...

Case 1: A 17-year-old female was referred to the endocrinology outpatients due to abnormal thyroid function tests (TFTs) (as below) detected on routine monitoring for Thyroxine replacement therapy. Following exclusion of pregnancy, possibilities of assay interference due to heterophilic antibodies as well as thyroid hormone resistance were considered. Repeat analysis was arranged at two laboratories using different methods. Results were concordant, excluding assay interference...

Background: The displacement of cortisol from its binding globulin (CBG) in the Abbott Alinity immunoassay assumes an average concentration of CBG in all individuals. Displacement buffer volume, and/or composition, is frequently insufficient to displace cortisol where higher concentrations of CBG are present (e.g. with higher oestrogen concentrations). To address this bias, the Eastern Pathology Alliance (EPA) introduced a 1:2 dilution step on all serum cortisol specimens in D...

Introduction: In cancer patients treated with immune checkpoint-inhibitors (ICI) that target CTLA-4, PD-1 and/or PD-L-1, thyroid dysfunction represents the commonest associated endocrinopathy (1). Patients receiving ICI should be monitored for thyroid dysfunction. A case of PD-1 inhibitor-induced thyroid function test (TFT) interference has been reported (2) and having noted discordant results, we undertook a preliminary assessment of the extent of such ICI-related TFT interfe...

Introduction: Immunoassays are important tools in the diagnosis and management of disease; however, they are not free from interference by cross-reacting substances. Discordant clinical evidence and laboratory results raised suspicion of interference in a patient with persistently raised parathyroid hormone.Case Presentation: Case description: A 56-year-old Caucasian female previously diagnosed with hypothyroidism consistently demonstrated elevated PTH l...