Thanks to everyone who responded to my query.
CBG is still offered by Charing Cross (contact Julia Jones).
Just for information:
People also suggested cross-reactivity, which is of course also very likely in this patient (but harder to demonstrate!).
Some also suggested salivary cortisol as a measure of free cortisol. At this stage my interest in the patient is academic as she has passed away, so there is no saliva available to test.
SHBG (as a proxy for CBG) was not particularly remarkable.
Mitotane elevates CBG, which can potentially lead to missed hypoadrenalism due to high results for serum cortisol - this patient had high levels before mitotane was commenced. She was also given hydrocortisone replacement after a few days on mitotane.
Kind regards,
Fiona
Principal Clinical Scientist
Barts Health NHS Trust
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