Cross reactions elicited by serum 17-OH progesterone and 11-desoxycortisol in cortisol assays

Julie Brossaud, Pascal Barat, Dominique Gualde, Jean-Benoît Corcuff
Clinica Chimica Acta. 2009-09-01; 407(1-2): 72-74
DOI: 10.1016/j.cca.2009.05.019

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1. Clin Chim Acta. 2009 Sep;407(1-2):72-4. doi: 10.1016/j.cca.2009.05.019. Epub 2009
May 28.

Cross reactions elicited by serum 17-OH progesterone and 11-desoxycortisol in
cortisol assays.

Brossaud J(1), Barat P, Gualde D, Corcuff JB.

Author information:
(1)Department of Nuclear Medicine, University Hospital and University of
Bordeaux, France.

BACKGROUND: Different pathophysiological situations such as congenital adrenal
hyperplasia, adrenocortical carcinoma, metyrapone treatment, etc. elicit
specificity problems with serum cortisol assay.
METHODS: We assayed cortisol using 2 kits and performed cross reaction studies as
well as multiple regression analysis using 2 other steroids: 11-desoxycortisol
and 17-OH progesterone.
RESULTS: Analysis showed the existence of an analytical bias. Importantly,
significantly different biases were demonstrated in newborns or patients taking
metyrapone. Multiple regression analysis and cross reaction studies showed that
11-desoxycortisol level significantly influenced cortisol determination.
Moreover, despite using the normal ranges provided by manufacturers discrepant
results occurred such as 17% discordance in the diagnosis of hypocorticism in
infants.
CONCLUSION: We wish to raise awareness about the consequences of the (lack of)
specificity of cortisol assays with regard to the evaluation of hypocorticism in
infants or when “unusual” steroids may be increased.

DOI: 10.1016/j.cca.2009.05.019
PMID: 19481537 [Indexed for MEDLINE]

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