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


CONCLUSIONS
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.
Brossaud
Julie
J
Department of Nuclear Medicine, University Hospital and University of Bordeaux, France. julie.brossaud@u-bordeaux2.fr
Barat
Pascal
P
Gualde
Dominique
D
Corcuff
Jean-Benoît
JB
D019326:17-alpha-Hydroxyprogesterone / Q000097:blood* / Q000276:immunology*; D000328:Adult; D016477:Artifacts; D001774:Blood Chemical Analysis / Q000379:methods*; D002648:Child; D003350:Cortodoxone / Q000097:blood* / Q000276:immunology*; D003429:Cross Reactions; D005260:Female; D006785:Hospitals, University; D006801:Humans; D006854:Hydrocortisone / Q000097:blood* / Q000276:immunology*; D007223:Infant; D008297:Male
D019326:17-alpha-Hydroxyprogesterone; D003350:Cortodoxone; D006854:Hydrocortisone