Hirsutism laboratory findings: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Hirsutism}} | {{Hirsutism}} | ||
{{CMG}} {{AE}} | {{CMG}};{{AE}} {{RHN}}, {{AY}} | ||
==Overview== | ==Overview== | ||
Laboratory tests that should be done in hirsutism include testosterone level, DHEAS, and 24-hour cortisol level. | |||
==Laboratory | ==Laboratory Finding== | ||
===Testosterone=== | |||
*Serum testosterone may be normal to increased in case of [[PCOS]] and [[CAH]] but would be definitely raised (>200 ng/ml) in case of [[malignant]] tumor of the [[Adrenal gland|adrenal]] or [[ovary]].<ref name="pmid18574213">{{cite journal |vauthors=Lin-Su K, Nimkarn S, New MI |title=Congenital adrenal hyperplasia in adolescents: diagnosis and management |journal=Ann. N. Y. Acad. Sci. |volume=1135 |issue= |pages=95–8 |year=2008 |pmid=18574213 |doi=10.1196/annals.1429.021 |url=}}</ref> | |||
* | ===DHEAS=== | ||
*[[DHEAS|Dehydroepiandrosterone sulfate (DHEAS)]]: Raised [[DHEAS]] (>700 μg/dl) always indicates an adrenal cause, [[benign]] or [[malignant]]. | |||
* [[Dehydroepiandrosterone sulfate | ===17-Hydroxyprogesterone=== | ||
* [[17-Hydroxyprogesterone|17 Hydroxy progesterone]]: Levels less than 200 ng/dl excludes [[CAH]]. Mildly increased levels between 300 and 1,000 ng/dl require an [[ACTH]] stimulation test. [[Cosyntropin]] (synthetic [[ACTH]]), 250 μg, is administered intravenously, and levels of [[17-Hydroxyprogesterone|17-hydroxyprogesterone]] are measured before and one hour after the injection. Post-stimulation values (>1,000 ng/dl) constitute a positive test.<ref name="pmid18574213">{{cite journal |vauthors=Lin-Su K, Nimkarn S, New MI |title=Congenital adrenal hyperplasia in adolescents: diagnosis and management |journal=Ann. N. Y. Acad. Sci. |volume=1135 |issue= |pages=95–8 |year=2008 |pmid=18574213 |doi=10.1196/annals.1429.021 |url=}}</ref> | |||
* [[ | ===24-hour urinary cortisol=== | ||
* Twenty four hour urine free [[cortisol]] should be measured in women with signs and symptoms of [[Cushing's syndrome]]. | |||
===LH/FSH ratio=== | |||
* [[LH]]/[[FSH]] greater than 3 is indicative of [[PCOS]].<ref name="pmid10352925">{{cite journal |vauthors=Chang RJ, Katz SE |title=Diagnosis of polycystic ovary syndrome |journal=Endocrinol. Metab. Clin. North Am. |volume=28 |issue=2 |pages=397–408, vii |year=1999 |pmid=10352925 |doi= |url=}}</ref> | |||
===Serum TSH=== | |||
* Serum [[TSH]] and [[Prolactin]]: [[Hypothyroidism]] and [[hyperprolactinemia]] can lead to hirsutism.<ref name="pmid1905280">{{cite journal |vauthors=Schmidt JB, Lindmaier A, Spona J |title=[Hyperprolactinemia and hypophyseal hypothyroidism as cofactors in hirsutism and androgen-induced alopecia in women] |language=German |journal=Hautarzt |volume=42 |issue=3 |pages=168–72 |year=1991 |pmid=1905280 |doi= |url=}}</ref> | |||
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==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Latest revision as of 13:43, 10 October 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Rasam Hajiannasab M.D.[2], Ahmed Younes M.B.B.CH [3]
Overview
Laboratory tests that should be done in hirsutism include testosterone level, DHEAS, and 24-hour cortisol level.
Laboratory Finding
Testosterone
- Serum testosterone may be normal to increased in case of PCOS and CAH but would be definitely raised (>200 ng/ml) in case of malignant tumor of the adrenal or ovary.[1]
DHEAS
- Dehydroepiandrosterone sulfate (DHEAS): Raised DHEAS (>700 μg/dl) always indicates an adrenal cause, benign or malignant.
17-Hydroxyprogesterone
- 17 Hydroxy progesterone: Levels less than 200 ng/dl excludes CAH. Mildly increased levels between 300 and 1,000 ng/dl require an ACTH stimulation test. Cosyntropin (synthetic ACTH), 250 μg, is administered intravenously, and levels of 17-hydroxyprogesterone are measured before and one hour after the injection. Post-stimulation values (>1,000 ng/dl) constitute a positive test.[1]
24-hour urinary cortisol
- Twenty four hour urine free cortisol should be measured in women with signs and symptoms of Cushing's syndrome.
LH/FSH ratio
Serum TSH
- Serum TSH and Prolactin: Hypothyroidism and hyperprolactinemia can lead to hirsutism.[3]
References
- ↑ 1.0 1.1 Lin-Su K, Nimkarn S, New MI (2008). "Congenital adrenal hyperplasia in adolescents: diagnosis and management". Ann. N. Y. Acad. Sci. 1135: 95–8. doi:10.1196/annals.1429.021. PMID 18574213.
- ↑ Chang RJ, Katz SE (1999). "Diagnosis of polycystic ovary syndrome". Endocrinol. Metab. Clin. North Am. 28 (2): 397–408, vii. PMID 10352925.
- ↑ Schmidt JB, Lindmaier A, Spona J (1991). "[Hyperprolactinemia and hypophyseal hypothyroidism as cofactors in hirsutism and androgen-induced alopecia in women]". Hautarzt (in German). 42 (3): 168–72. PMID 1905280.