Endocrine Abstracts

IntroductionThyrotropin-secreting pituitary adenomas (TSH-omas) are rare. For this reason each case of TSH-secreting pituitary tumor can help expand extensive clinical experience in world practice.Materials and methodsWe included 40 patients with TSH secreting pituitary adenomas. Hormonal profile: TSH (0.25-3.5 mIU/L), FT4 (9-20 pmol/l) FT3 (2.5-5.5 pmol/l) were measured by Architect i2000SR (Abbott Laborator...

Background: Short Synacthen Tests (SSTs) are integral to the diagnosis of Adrenal Insufficiency (AI). A 30-minute stimulated cortisol value is assessed against local assay dependent thresholds to ascertain or exclude the diagnosis. A diagnosis of AI is a life changing event requiring the initiation of life long glucocorticoid replacement therapy for survival. Glucocorticoid replacement is associated with long term morbidity and mortality, including an increased risk of diabete...

Introduction: Current clinical practice guidelines recognise that a calculated free testosterone (T) level is the single most-useful, clinically sensitive marker of androgen excess in women, but there is no clear guidance as to the best way to measure free T. Several equations have been proposed to calculate clinically useful estimates of free T including the free androgen index (FAI) and calculated free T (cFT). The FAI is not used in men but it is...

Sex hormone binding globulin (SHBG) is a glycoprotein which binds hormones such as testosterone. Around 97% of circulating testosterone is bound to SHBG and is therefore biologically unavailable; approximately 2–3% of testosterone is free or loosely bound to proteins such as albumin, and is biologically active, or bioavailable. Free testosterone is very technically challenging to quantify; in order to circumvent this problem, equations are used...

Introduction: Current clinical practice guidelines recognise that a calculated free testosterone (T) level is the single most-useful, clinically sensitive marker of androgen excess in women, but there is no clear guidance as to the best way to measure free T. Several equations have been proposed to calculate clinically useful estimates of free T including the free androgen index (FAI) and calculated free T (cFT). The FAI is not used in men but it is...

Sex hormone binding globulin (SHBG) is a glycoprotein which binds hormones such as testosterone. Around 97% of circulating testosterone is bound to SHBG and is therefore biologically unavailable; approximately 2–3% of testosterone is free or loosely bound to proteins such as albumin, and is biologically active, or bioavailable. Free testosterone is very technically challenging to quantify; in order to circumvent this problem, equations are used...

Objectives: Thyroglobulin (Tg) is an established tumor marker for differentiated thyroid carcinoma (DTC) patients. However, Tg immunoassays can be subject to autoantibody (TgAb) interference resulting in incorrect Tg values. Tg measurement with liquid chromatography-tandem mass spectrometry (LC-MS/MS) could be promising in patients with TgAbs. In this study, we compared a Tg immunoradiometric assay (Tg-IRMA) and a Tg-LC-MS/MS analytically in the presence of TgAbs. Furthermore,...

Background: Adrenal Insufficiency (AI) presents a diagnostic and clinical challenge. While short Synacthen Tests (SSTs) are most commonly utilised to diagnose AI, the value of a baseline cortisol is being explored. We aimed to review indications for performing an SST and to determine the baseline cortisol that predicted a preserved cortisol response to Synacthen.Methods: Eight hundred and sixty SSTs performed in 621 individuals at a tertiary endocrinolog...

Background: Elevated TSH concentration should be assessed and treated with caution because of the possibility of transient thyroid dysfunction, or, in rare cases, measurement interference. We describe a case with a rare cause of elevated TSH level in a 39-year-old mother and her four children.Case Summary: A 39-year-old lady was referred with a long history of high serum TSH ranging between 18.9 to 38.7 (reference interval 0.4-4.0 mU/l) with FT4 concentr...

Aim: Recent studies reported a wide range in baseline and peak cortisol responses to surgery. We report the results of cosyntropin stimulation testing following unilateral adrenalectomy for non-steroid secreting lesions.Methods: Data of 36 patients who underwent cosyntropin stimulation testing on the second day post unilateral adrenalectomy were collected retrospectively. None of the patients had clinical signs of hypercortisolism. No patient received pr...