Recommendations for investigation of hyperandrogenism
Autor: | Michel Pugeat, R. Cohen, A. Denuzière, H. Déchaud, V. Raverot, P. Boudou |
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Rok vydání: | 2010 |
Předmět: |
medicine.medical_specialty
Adenoma Endocrinology Diabetes and Metabolism Mass Spectrometry Endocrinology Sex hormone-binding globulin Insulin resistance Reference Values Internal medicine medicine Humans Testosterone hirsutism Immunoassay biology Dehydroepiandrosterone Sulfate business.industry Hyperandrogenism Androstenedione Testosterone (patch) General Medicine medicine.disease Polycystic ovarian disease Research Design biology.protein Female Metabolic syndrome business hormones hormone substitutes and hormone antagonists |
Zdroj: | Annales d'Endocrinologie. 71:2-7 |
ISSN: | 0003-4266 |
DOI: | 10.1016/j.ando.2009.12.007 |
Popis: | 1. Total testosterone assay is recommended as the first-line approach. 2. Radioimmunological assay following prior treatment of the sample (extraction or extraction + chromatography) is the recommended method pending wider experience with mass spectrometry. 3. Where testosterone is twice the upper limit of normal, it is recommended that DHEAS assay be performed. DHEAS is primarily of cortico-adrenal origin in women. Thus, a DHEAS level over 600 mg/dl indicates a diagnosis of androgen-secreting adrenal cortical adenoma.. If DHEAS is normal, the diagnosis could be either ovarian hyperthecosis, normally associated with insulin resistance, or androgen-secreting ovarian tumour. 4. More rarely, elevated testosterone is associated with a marked elevation of SHBG possibly as the result of use of medication having an estrogenic effect (tamoxifen, raloxifene, Op'DDD), or of hyperthyroidism or liver disease. 5. Normal testosterone levels in patients with clear clinical symptoms of hyperandrogenism (hirsutism, seborrhoeic acne) must be interpreted with care. SHBG is normally reduced in the event of overweight, metabolic syndrome or familial history of diabetes. |
Databáze: | OpenAIRE |
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