Trevor
Why not just do a 24 hr urine steroid profile? Shouldn't that answer
all the questions?
Happy new year!
Cathryn Corns
Consultant Biochemist
& Head of Biochemistry
01702 435555 ext 6614
________________________________
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]] On Behalf Of TICKNER TREVOR
(RM1) Norfolk and Norwich University Hospital
Sent: 29 December 2008 16:30
To: [log in to unmask]
Subject: Help/comments please
I have received the following request for help from an endocrinologist.
I do not know of anyone offering DHEA rather than DHEAS assay.
Can anyone help or can anyone offer an alternative approach?
Thanks,
Trevor Tickner,
Norwich
I am due to see a lady this week called XXXXXXXXXXXX, dob 1/7/49,
hospital number XXXXXXX. She has MS, but is unusual because she was
referred to us with odd symptoms, which were diagnosed as reactive
hypoglycaemia on the basis of a prolonged OGTT. However, she continued
to feel quite unwell and she was unhappy with the diagnosis.
She came to see me and on talking to her she had a few other symptoms
that led me to believe that she may have adrenal disease (in particular
recent loss of pubic and axially hair, de-pigmentation of her nipples).
Her 9 am cortisol was normal, but she has no DHEAS. I don't think I have
ever seen this (and much of my entire research has been on this elusive
hormone!). I want to get her to have a short synacthen test, but would
like to test her CYP17(b) pathway by measuring her androgens. That would
test her 17beta HSD / 17 ketosteroid reductase and CYP 19 pathways.
If possible is it possible to test the activity of her DHEA levels and
compare them to her DHEAS levels to assess her 3 beta hydroxysteroid
sulphotransferase / sulphohydrolayse activity?
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