Falsely Elevated Serum Testosterone Levels in a Young Adult Female with Polycystic Ovarian Syndrome (PCOS) and Left Adrenal Adenoma

  • Yin Chian Kon Department of Endocrinology, Tan Tock Seng Hospital, Singapore
  • Robert Hawkins Department of Laboratory Medicine, Tan Tock Seng Hospital, Singapore

Abstract

Serum testosterone immunoassay interference may cause falsely high results. We report a case of 20-year-old female with PCOS whose initial serum testosterone levels were more than 10 nM. Further imaging revealed a left adrenal adenoma. During an attempt at bilateral adrenal-ovarian venous sampling at another institution, her peripheral serum total testosterone levels on a different assay platform were surprisingly normal. Subsequently, simultaneous samples performed on three different assay platforms confirmed the presence of assay interference from the originating institution.

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References

Kane J, Midddle J, Cawood M. Measurement of serum testosterone in women; what shall we do? Ann Clin Biochem 2007;44:5-15e

Stanczyk FZ, Cho MM, Endres DB, et al. Limitations of direct estradiol and testosterone immunoassay kits. Steroids 2003;68:1173-8

Kaltsas GA, Isidori AM, Kola BP, et al. The value of low-dose dexamethasone suppression test in the differential diagnosis of hyperandrogenism in women. J Clin Endocrinol Metab 2003;88:2634-43

Futterweit W, Diamanti-Kandarakis E, Azziz R. Clinical features of the polycystic ovarian syndrome. Androgen Excess Disorders in Women, Chapter 14. Humana Press, 2007.

Arroyo A, Laughlin GA, Morales AJ, et al. Inappropriate gonadotrophin secretion in polycystic ovary syndrome: influence of adiposity. J Clin Endocrinol Metab 1997;82:3728-33

Cordera F, Grant C, van Heerden J, et al. Androgen secreting adrenal tumours. Surgery 2003;134:874-80

Pugeat M, Raverot G, Plotton I, et al. Androgen-secreting adrenal and ovarian neoplasms. Androgen Excess Disorders in Women, Chapter 6. Humana Press, 2007.

Legro R, Schlaff WD, Diamond MP. Total testosterone assays in women with polycystic ovary syndrome: Precision and correlation with hirsutism. J Clin Endocrinol Metab 2010;95:5305-13

Derksen J, Nagesser SK, Meinders AE. The identification of virilizing adrenal tumours in hirsute women. N Eng J Med 1994;331:968-73

d’ Alva CB, Abiven Lepage G, Viallon V, et al. Sex steroids in androgen-secreting adrenocortical tumours: Clinical and hormonal features in comparison with non-tumoral causes of androgen excess. European Journal of Endocrinology 2008;159:641-7.

Kaltsas GA, Mukherjee JJ, Kola B, et al. Is ovarian and adrenal venous catheterization helpful in the investigation of hyperandrogenic women? Clinical Endocrinology 2003;59:34-43

Sorensen R, Moltz L, Schwartz U. Technical difficulties of selective venous blood sampling in the differential diagnosis of female hyperandrogenism. Cardiovasc Intervent Radiol 1986;9:75-82

Kirschner MA, Jacobs JB. Combined ovarian and adrenal catheterization to determine the site of androgen overproduction in hirsute women. J Clin Endocrinol 1971;33:199-209

Srikugan L, Sankaralingam A, McGowan B. First case report of testosterone assay-interference in a female taking maca (Lypedium meyenni). BMJ Case Reports 2011;doi:10.1136/bcr.01.2011.3781

Published
2014-05-25
How to Cite
Kon, Y. C., & Hawkins, R. (2014). Falsely Elevated Serum Testosterone Levels in a Young Adult Female with Polycystic Ovarian Syndrome (PCOS) and Left Adrenal Adenoma. Journal of the ASEAN Federation of Endocrine Societies, 28(2), 159. Retrieved from https://asean-endocrinejournal.org/index.php/JAFES/article/view/70
Section
Case Reports