Clinical Use
1 Diagnosis of a virilizing adrenal tumour and monitoring recurrence after surgical removal.
2 Differential diagnosis of Cushing’s syndrome due to an adrenal adenoma.
Applications
The assay has little value in the investigation of acne, idiopathic hirsutism or infertility.
1 Virilizing adrenal tumours.
These are often associated with an increased production of dehydroepiandrosterone sulphate which can be detected by analysis of serum or urine. Measurement is indicated in women if hirsutism and/or virilization is of sudden onset and in prepubertal children when pubic/axillary hair appears prematurely or there are other features of masculinization.
2 Cushing’s syndrome.
Serum values below the normal reference range have been described in patients with cortisol excess due to adrenal adenoma.
Patient Preparation
None. Take blood (5 mL), into a plain tube, or collect a 24h urine specimen. After surgery, samples should be taken as soon as practicable and at least every 2 months thereafter to monitor for recurrence.
Sample Preparation
Serum: Send serum (2 mL) to the SAS laboratory.
Urine: Send 50 mL from a 24h urine collection (record the volume on the SAS request form) to the SAS laboratory.
Reference Ranges
Serum:
(Age-related reference ranges for adults are available from each Centre)
Pre-adrenarche: <0.5 mmol/L;
Adult males: 4-13 mmol/L (falling to <6 mmol/L by age 70);
Adult females: 3-11 mmol/L (falling to <5 mmol/L by age 70).
Urine:
Adult males and females: <10 mmo1/24h;
Prepubertal children: <1 mmol/24h.
Centres offering this assay
Serum:
Urine: