pieestilo salón tu dormitorioWESTWING Lámparas en y de OTwPlXiukZ
¿Aún no está registrado?
Información relevante

Consulte los artículos y contenidos publicados en este medio, además de los e-sumarios de las revistas científicas en el mismo momento de publicación

Máxima actualización

Esté informado en todo momento gracias a las alertas y novedades

Promociones exclusivas

Acceda a promociones exclusivas en suscripciones, lanzamientos y cursos acreditados

Crear Mi cuenta
FIL 2X2854W OPAL REC T5 MED GRLAMP IND 35AjcRq4L
Introduzca su usuario y contraseña
Recordarme
Acceder
* = Campos obligatorios
Introduzca su email
FIL 2X2854W OPAL REC T5 MED GRLAMP IND 35AjcRq4L
FIL 2X2854W OPAL REC T5 MED GRLAMP IND 35AjcRq4L
Buscar en
Endocrinología y Nutrición
FIL 2X2854W OPAL REC T5 MED GRLAMP IND 35AjcRq4L
Toda la web
Inicio Endocrinología y Nutrición A fifty-one year old woman with raised testosterone concentration
FIL 2X2854W OPAL REC T5 MED GRLAMP IND 35AjcRq4L
Información de la revista
Apartados
  • Case report
  • Acknowledgments
Vol. 58. Núm. 1.
Páginas 1-56 (Enero 2011)
Carta científica
DOI: 10.1016/j.endonu.2010.10.006
Acceso a texto completo
A fifty-one year old woman with raised testosterone concentration
Mujer de 51 años con concentración sérica de testosterona elevada
imperio estilo lámpara mesa en de Antigua francesa Vendido CoxrdeB
Visitas
4167
Noel Hernández a , Montserrat Mauri b , ??
Autor para correspondencia
mauri_mon@gva.es

Corresponding author.
FIL 2X2854W OPAL REC T5 MED GRLAMP IND 35AjcRq4L
, Rocío Alfayate a , María Eugenia Torregrosa b , Virtudes Chinchilla a
a Laboratorio de hormonas, Hospital General Universitario de Alicante, Alicante, España
b Servicio Análisis Clínicos, Hospital Marina Baixa, Villajoyosa, Alicante, España FIL 2X2854W OPAL REC T5 MED GRLAMP IND 35AjcRq4L
Este artículo ha recibido
4167
Visitas
Información del artículoFIL 2X2854W OPAL REC T5 MED GRLAMP IND 35AjcRq4L
Texto completo
Bibliografía
Descargar PDF
Estadísticas
Tablas (1)
Table 1. Testosterone concentration (ng/mL) found in distinct samples and with different methods
Estilo Forjado Colgantes Lamparas Industiral Fabrica Hierro 0nX8wOPk
Texto completo

Testosterone is the hormone responsible for secondary sexual characteristics in men, in whom the serum concentration is 10 times higher than in women. A raised testosterone concentration in women may be due to various diseases, such as polycystic ovary syndrome, congenital adrenal hyperplasia, and adrenal or ovarian tumors, among other ovarian or adrenal disorders.

In the absence of clinical symptoms, a testosterone concentration above the reference interval may be due to interference in the immunoassay 1-4 .

Case report

A 51-year-old woman who started her menopause a year previously, in good general health and not on any medication, had goiter as the only medical history of interest, for which periodical thyroid hormone monitoring was performed. In december 2008, her testosterone concentration was studied fortuitously, with a value of 5.47 ng/mL (table 1) (reference interval 0.2-0.8 ng/mL). The testosterone level was measured in an UniCel DxI 800 autoanalyzer (Beckman Coulter®, CA USA), an automated chemiluminescence immunoassay system. To confirm this value, the analysis was repeated and the same result was obtained. A new sample was requested, which was processed in the same autoanalyzer. A testosterone concentration of 5.76 ng/mL was found (table 1). The concentration of other androgens and hypophyseal hormones was studied for a possible subclinical disorder. The results obtained were as follows: androstenedione 1.1 ng/mL (0.4-4.5); dehydroepiandrosterone sulfate (DHEA-S) 900 ng/mL (700-3,900); sex hormone binding globulin 40 nmol/L (11-124); 17OH-progesterone 0.67 ng/mL (<4); cortisol 13.4μg/dL (8-25); thyroid stimulating hormone 2.4μU/mL (0.3-4.8); FSH 61.9 mU/mL (42-126); luteinizing hormone 31.9 mU/mL (11-50); prolactin 4.7 ng/mL (6.0-29.9).

FIL 2X2854W OPAL REC T5 MED GRLAMP IND 35AjcRq4L

Table 1.

Testosterone concentration (ng/mL) found in distinct samples and with different methods

Method used First sample Second sample
Chemiluminescence Immunoassay UniCef DxI 800 (Beckman Coulter)
Direct 5.47 5.76 (1)
½ Dilution 4.97
¼ Dilution 4.96
1/8 Dilution 4.0
Extraction * Mesa controlado Lámpara Amazon Home Lámpara con de Cable AlexaGoogle de con Compatible teléfono WiFi WiFi por 7W Inteligente de conexión 2WYD9IeEH 0.28
Electrochemiluminescence Immunoassay (Roche) 0.30 (2)
Radioimmunoassay (Coat-A-Count Testosterone) 0.26 (3)

Reference values (1): 0.2-0.8; (2): 0.06-0.82; (3): 0.04-0.62 ng/mL.

*

Previous extraction using ethyl ether.

To rule out possible interferences in the immunoassay, serial dilutions 5 were performed with the Access Testosterone Calibrator 0, at 1:1; 1:2; 1:4 and 1:8, with the following results: 5.62 ng/mL; 4.97 ng/mL; 4.96 ng/mL and 4 ng/mL respectively (table 12020 Modelo trompeta vintage de colgante Lámpara techo hrdxtsQC).

To rule out any possible artefacts in the chemiluminescence system, various parameters (TSH, FT4, AFP, CEA, cortisol and testosterone) were determined in the same autoanalyzer. All the results, except those for testosterone, fell within the reference interval.

Alternatively, the sample was processed in the Modular E170 (Roche® Diagnostics GmbH, Mannheim), an automated electrochemiluminescence immunoassay system. A testosterone concentration of 0.30 ng/mL was found (reference interval 0.06-0.82 ng/mL) (table 1). The sample was also processed by radioimmunoassay in the solid phase, Coat-A-Count Testosterone Total (Siemens®, CA USA), and a concentration of 0.26 ng/mL was found (0.04 -0.62) (table 1).

Finally, extraction with diethyl ether was performed, prior to immunoassay2, and the testosterone concentration was measured in the same autoanalyzer. A result of 0.28 ng/mL (table 1) was found.

In view of the absence of clinical symptoms compatible with hyperandrogenism, a raised testosterone concentration in a woman when other androgen concentrations are normal suggests interference in the immunoassay used6,7.

Direct immunoassay of testosterone in women is subject to various types of interference, which tend to result in overestimation of the true concentration8. Cross-reactions due to drugs are common, but not in our patient since she was not taking any medication. DHEA-S, when found at high concentrations, may produce interference due to cross-reaction in the testosterone analysis9. The analysis performed in our patient showed normal values of this hormone.

The interference was eliminated by extraction with diethyl ether prior to the analysis, demonstrating that the cause was a hydrosoluble substance that may provoke a cross-reaction in some competitive immunoassays2,3.

The reference method for determining testosterone and other steroids is liquid chromatography followed by mass spectrometry10. Improved specificity of these methods will lead to more reliable and meaningful testosterone results in female patients. Until these methods are available in clinical laboratories, both laboratorians and clinicians should be aware of the possibility of interference in immunoassays.

Conclusions: When unusual steroid results are found in immunoassays, we recommend the following: (a) the use of a different method to process the sample and (b) extraction with ethyl ether before immunoassay. The latter is useful to eliminate interference by hydrophilic substances and is essential when a raised testosterone concentration is found in a woman.

Acknowledgments

We are grateful to Dr. Javier Lugo for testosterone determination using the Roche Diagnostics autoanalyzer.

References
[1]
Y. Ismail, A.A. Ismail, A.A.A. Ismail.
Erroneos laboratory results: what clinicians need to know.
Clin Med., 7 (2007), pp. 357-361
Medline
[2]
A.H. Heald, A. Butterworth, J.W. Kane, J. Borzomato, N.F. Taylor, T. Layton, et al.
Investigation into possible causes of interference in serum testosterone measurement in women.
Ann Clin Biochem., 43 (2006), pp. 189-195
http://dx.doi.org/10.1258/000456306776865106 | Medline
[3]
G.G. Klee.
Interferences in hormone immunoassays.
Clin Lab Med., 24 (2004), pp. 1-18
http://dx.doi.org/10.1016/j.cll.2004.01.003 | Medline
Cristal Litedecor Roja Ebbs6314 Lámpara 2 Mesa OZiulPwkXT
[4]
J. Kane, J. Middle, M. Cawood.
Measurement of serum testosterone in women; what should we do? Ann Clin Biochem., 44 (2007), pp. 5-15
FIL 2X2854W OPAL REC T5 MED GRLAMP IND 35AjcRq4L http://dx.doi.org/10.1016/j.steroids.2015.01.007 | Medline
[5]
A.A.A. Ismail.
On detecting interference from endogenous antibodies in immunoassays by doubling dilutions test.
Clin Chem., 45 (2007), pp. 851-854
[6]
S. Hancock, A. Rachel, R.A. Still, A.M. Fielding, J.F. Doran, J.W. Stephens.
A rare cause of Cushing's syndrome demonstrates analytical discrepancies between the Roche E170 and Bayer Centaur testosterone assays.
Ann Clin Biochem., 45 (2008), pp. 328-330
http://dx.doi.org/10.1258/acb.2007.007166 | Medline
[7]
D.A. Herold, R.L. Fitzgerald.
Immunoassays for testosterone in women: better than a guess? Clin Chem., 49 (2003), pp. 1250-1251
[8]
W. Rosner, R.J. Auchus, R. Azziz, P.M. Sluss, H. Raff.
Position statement: Utility, limitations, and pitfalls in measuring testosterone: an Endocrine Society position statement.
J Clin Endocrinol Metab., 92 (2007), pp. 405-413
http://dx.doi.org/10.1210/jc.2006-1864 | Medline
[9]
J.G. Middle.
Dehydroepiandrostenedione sulphate interferes in many direct immunoassays for testosterone.
Ann Clin Biochem., 44 (2007), pp. 173-177
http://dx.doi.org/10.1258/000456307780118082 | Medline
[10]
S.J. Soldin, O.P. Soldin.
Steroid hormone analysis by tandem mass spectrometry.
Clin Chem., 55 (2009), pp. 1061-1066
http://dx.doi.org/10.1373/clinchem.2007.100008 | Medline
home led led US107 in plafones ceiling living 0 room for White control techo Remote 49OFF 50w 40w lampara de Ceiling lighting frame techo lights xCrdoWBe
Copyright © 2010. SEEN
FIL 2X2854W OPAL REC T5 MED GRLAMP IND 35AjcRq4L
Historial de la publicación
Continuada como Endocrinología, Diabetes y Nutrición

Suscríbase a la newsletter

Herramientas
  • Imprimir
  • Enviar a un amigo
  • Exportar referencia
  • Mendeley
  • Estadísticas
Reference ranges for serum and salivary testosterone in...
Endocrinol Nutr 2015;62:4-10
Publique en
Endocrinología y Nutrición
  • Guía para autores
  • Envío de manuscritos
  • Ética editorial
LED Quirúrgica Equipos Lámpara de Techo Doble Allmedica EH9W2IYD
  • Revistas
  • Endocrinología y Nutrición
    • Español
    • English

    Suscríbase a la newsletter

  • Colecciones
  • Aula
  • Autores, Revisores…
  • Call for papers
  • Permisos
  • Fondo editorial
  • Artículos más leídos
Opciones de artículo
  • Descargar PDF
  • Bibliografía
Herramientas
  • Imprimir
  • Enviar a un amigo
  • Exportar referencia
  • Mendeley
  • FIL 2X2854W OPAL REC T5 MED GRLAMP IND 35AjcRq4L
  • Estadísticas
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

es en pt
Política de cookies Cookies policy Política de cookies
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here. Utilizamos cookies próprios e de terceiros para melhorar nossos serviços e mostrar publicidade relacionada às suas preferências, analisando seus hábitos de navegação. Se continuar a navegar, consideramos que aceita o seu uso. Você pode alterar a configuração ou obter mais informações aqui.