A rare cause of Cushing’s syndrome demonstrates analytical discrepancies between the Roche E170 and Bayer Centaur testosterone assays

Ann Clin Biochem 2008;45:328-330
© 2008 Association for Clinical Biochemistry


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Case Reports

Sian Hancock1,
Rachel A Still1,
Andrew M Fielding1,
John F Doran1 and
Jeffrey W Stephens2

1 Chemical Pathology Services;
2 Department of Medicine, Swansea NHS Trust, Morriston Hospital, Swansea SA6 6NL, UK

Corresponding author: Dr Sian Hancock. Email: sian.hancock{at}swansea-tr.wales.nhs.uk

The initial biochemical investigations of a female patient withsuspected Cushing’s syndrome revealed abnormal endocrine results,including a marked elevation of serum testosterone. Overnightand low-dose dexamethasone suppression tests confirmed the diagnosisof Cushing’s syndrome. Imaging investigations revealed an appearancecompatible with adrenocortical carcinoma with metastases inthe lungs and liver. This tumour is a rare cause of Cushing’ssyndrome. Two different automated testosterone immunoassayswere used during the investigation of this patient, and analyticaldiscrepancies in the patient’s testosterone results were found.The two assays used, as well as potential causes of the differencein results will be discussed.

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