Endocrine Abstracts

Introduction: Familial dysalbuminemic hyperthyroxinemia (FDH) is characterized by artefactual hyperthyroxinemia caused by enhanced binding affinity of thyroxine to the mutant albumin. However little is known about how FDH affects the measurement of thyroid hormones, especially FT3, across many assay platforms.Methods: Forty-eight genetically confirmed FDH patients (R218H mutation) had FT4 and FT3 measured with 1-step (ADVIA CENTAUR®, Siem...

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...

Introduction and aims: The short Synacthen test (SST) is used to diagnose underactivity of the HPA axis, with a cortisol response <550 nmol/l at 30 min widely accepted as diagnostic of adrenal insufficiency. Earlier studies of the SST have shown variation in cortisol concentrations measured by different immunoassays, suggesting the need for method-specific cut-offs. We sought to define the cortisol response to Synacthen in healthy volunteers (HV) and establish method-speci...

The short Synacthen test (SST) is used to evaluate adrenal glucocorticoid secretion in response to synthetic ACTH (also known as tetracosactide or Synacthen). Traditionally, after a baseline cortisol and ACTH, two plasma cortisol samples have been taken after i.v. or i.m. administration of Synacthen 250 μg, one at 30 min and one at 60 min. However practice varies and some physicians only take one cortisol measurement at 30 min.Hypothesis: A protocol...

Measurement of urinary free cortisol (UFC) in overnight, early morning and 24h sample collections are often used to assess potential effects of inhaled or intranasal corticosteroids (ICS) on the HPA axis. In the present study the effects of single inhaled doses of fluticasone propionate (FP), Budesonide (Bud), Triamcinolone acetate (TAA)(molar equivalence; 1750, 1600 and 1600 micrograms respectively) and placebo on UFC excretion was investigated in 13 healthy male subjects. UF...

Sheue-yann Cheng, Gene Regulation Section, National Institutes fo Health, Bethesda, MD, USA AbstractSheue-yann Cheng, PhD, is the chief of the Gene Regulation Section, Laboratory of Molecular Biology, National Cancer Institute (NCI), National Institutes of Health (NIH) and an advisor for women scientists at the Center for Cancer Research, NCI. She is on the editorial boards of Thyroid, Endocrinology, and Expert Revi...

Introduction: High androgen levels and infertility in reproductive women, beyond the most common cause of polycystic ovary syndrome (PCOS), is often a challenge diagnosis. Ovarian steroid cell tumor is considered a rare subtype of hormone-secreting ovarian tumor, accounting for about 0.1% of all ovarian tumors.Aim: To report a case of extremely high testosterone levels in a woman with secondary amenorrhea but without signs of virilization, and describe d...

A 31-year-old man originally from Ukraine attended the clinic having been started on Carbimazole 20 mg by his GP. His symptoms included intermittent palpitations, sweating and poor sleep and they had improved since starting anti-thyroid therapy. He was originally diagnosed with thyrotoxicosis in Germany in 1999 but was not treated and he re-presented in 2005. This time he was started on Carbimazole but stopped treatment on his own accord after a month because his symptoms impr...

Background: NEQAS data demonstrate a divergence in bias of cortisol immunoassays over the last 10 years. Despite this, a serum cortisol of 50 nmol/l has been universally applied as the cut-off for the overnight dexamethasone suppression test (ONDST), the commonest screening test for Cushing’s syndrome.Aims: To assess the effect of assay bias on interpretation of the ONDST and determine the necessity for a method-specific cut-off.<p class="abstex...

Introduction: There is evidence that an early morning plasma cortisol (EMC) below <160 nmol/l is predictive of failing the SST and the corollary is seen with an EMC above >340 nmol/l. Using an EMC to screen patients for AI has been advocated, although there is a paucity of paediatric studies. Modern sensitive and specific cortisol assays make deriving local diagnostic thresholds important. We analysed our SST data since the introduction of a new cortisol assay to deriv...