Hirsutism laboratory findings: Difference between revisions
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{{Hirsutism}} | {{Hirsutism}} | ||
{{AE}} | |||
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==Overview== | ==Overview{{CMG}}== | ||
It is important to carry out various biochemical tests to determine the cause of hirsutism that is necessary to make an informed decision for the best options for treatment. | It is important to carry out various biochemical tests to determine the cause of hirsutism that is necessary to make an informed decision for the best options for treatment. | ||
==Laboratory Finding== | ==Laboratory Finding== | ||
* Testosterone | * [[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> | ||
* Dehydroepiandrosterone sulfate (DHEAS) | * [[DHEAS|Dehydroepiandrosterone sulfate (DHEAS)]] : Raised [[DHEAS]] (>700 μg/dl) always indicates an adrenal cause, [[benign]] or [[malignant]]. | ||
* 17 Hydroxy progesterone | * [[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> | ||
* Twenty four hour urine free cortisol should be measured in women with signs and symptoms of Cushing's syndrome. | * Twenty four hour urine free [[cortisol]] should be measured in women with signs and symptoms of [[Cushing's syndrome]]. | ||
* 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> | * [[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]] 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> | |||
* Serum TSH: | |||
==References== | ==References== | ||
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Associate Editor(s)-in-Chief:
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OverviewEditor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
It is important to carry out various biochemical tests to determine the cause of hirsutism that is necessary to make an informed decision for the best options for treatment.
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]
- Dehydroepiandrosterone sulfate (DHEAS) : Raised DHEAS (>700 μg/dl) always indicates an adrenal cause, benign or malignant.
- 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]
- Twenty four hour urine free cortisol should be measured in women with signs and symptoms of Cushing's syndrome.
- 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.