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The utility of three different methods for measuring urinary 18-hydroxycortisol in the differential diagnosis of suspected primary hyperaldosteronism

The utility of three different methods for measuring urinary 18-hydroxycortisol in the differential diagnosis of suspected primary hyperaldosteronism
The utility of three different methods for measuring urinary 18-hydroxycortisol in the differential diagnosis of suspected primary hyperaldosteronism
Objective: Urine 18-hydroxycortisol (18-OHF) measurements are claimed to discriminate between primary hyperaldosteronism due to Conn’s syndrome/adrenal adenoma or idiopathic bilateral adrenal hyperplasia (BAH), and also to identify cases of glucocorticoid-suppressible hyperaldosteronism (GSH). We have evaluated three urine 18-OHF methods using a panel of urine samples from patients with hypertension.
Design: Clinical methods comparative study.
Methods: Urine samples from patients with primary hyperaldosteronism due to either adenoma (n = 6), BAH (n = 6), GSH (n = 9), or essential hypertension (n = 38) were analysed without knowledge of the diagnosis using three different methods in different laboratories. These included ‘in-house’ radioimmunoassay (RIA), ‘in-house’ time-resolved fluorometric assay (DELFIA), and gas chromatography mass spectrometry (GC-MS).
Results: The three assays showed good correlation, but there were large bias differences: RIA bias was greater than DELFIA which was greater than GC-MS. Discrimination between adenoma and BAH patients was best for the DELFIA method, with no overlap between results for these two groups. All three methods gave significantly elevated results for the GSH group compared with the BAH and essential hypertension groups. No assay distinguished BAH from essential hypertension.
Conclusion: Measurement of urine 18-OHF may be a useful additional test in the differential diagnosis of primary hyperaldosteronism. The clinical diagnostic value of urinary 18-OHF measurements is method-dependent with the DELFIA assay having the best discriminatory value.
nonparametric, fluorometry, hypertension, endocrinology, comparative study, diagnosis, design, statistics, hyperaldosteronism, urine, congenital, random allocation, methods, mass fragmentography, laboratories, analogs & derivatives, clinical medicine, hydrocortisone, patients, differential, evaluation studies, radioimmunoassay, adrenal hyperplasia, adenoma, humans
0804-4643
903-907
Reynolds, R.M.
759e6564-c400-49c4-b245-2e6a85583947
Shakerdi, L.A.
09c876fe-b7f5-4371-849a-af03fce33256
Sandhu, K.
bf79908a-2da3-4b6f-bdd4-1627487cbcd7
Wallace, A.M.
54b1fe10-7f46-4081-9fe9-2a023e6b26ec
Wood, P.J.
f0dfe718-fa0f-43b1-9b2d-4bdc9c41320a
Walker, B.R.
d292ba5e-9070-49a2-aa09-cf1501bc99b4
Reynolds, R.M.
759e6564-c400-49c4-b245-2e6a85583947
Shakerdi, L.A.
09c876fe-b7f5-4371-849a-af03fce33256
Sandhu, K.
bf79908a-2da3-4b6f-bdd4-1627487cbcd7
Wallace, A.M.
54b1fe10-7f46-4081-9fe9-2a023e6b26ec
Wood, P.J.
f0dfe718-fa0f-43b1-9b2d-4bdc9c41320a
Walker, B.R.
d292ba5e-9070-49a2-aa09-cf1501bc99b4

Reynolds, R.M., Shakerdi, L.A., Sandhu, K., Wallace, A.M., Wood, P.J. and Walker, B.R. (2005) The utility of three different methods for measuring urinary 18-hydroxycortisol in the differential diagnosis of suspected primary hyperaldosteronism. European journal of endocrinology, 152 (6), 903-907. (doi:10.1530/eje.1.01922).

Record type: Article

Abstract

Objective: Urine 18-hydroxycortisol (18-OHF) measurements are claimed to discriminate between primary hyperaldosteronism due to Conn’s syndrome/adrenal adenoma or idiopathic bilateral adrenal hyperplasia (BAH), and also to identify cases of glucocorticoid-suppressible hyperaldosteronism (GSH). We have evaluated three urine 18-OHF methods using a panel of urine samples from patients with hypertension.
Design: Clinical methods comparative study.
Methods: Urine samples from patients with primary hyperaldosteronism due to either adenoma (n = 6), BAH (n = 6), GSH (n = 9), or essential hypertension (n = 38) were analysed without knowledge of the diagnosis using three different methods in different laboratories. These included ‘in-house’ radioimmunoassay (RIA), ‘in-house’ time-resolved fluorometric assay (DELFIA), and gas chromatography mass spectrometry (GC-MS).
Results: The three assays showed good correlation, but there were large bias differences: RIA bias was greater than DELFIA which was greater than GC-MS. Discrimination between adenoma and BAH patients was best for the DELFIA method, with no overlap between results for these two groups. All three methods gave significantly elevated results for the GSH group compared with the BAH and essential hypertension groups. No assay distinguished BAH from essential hypertension.
Conclusion: Measurement of urine 18-OHF may be a useful additional test in the differential diagnosis of primary hyperaldosteronism. The clinical diagnostic value of urinary 18-OHF measurements is method-dependent with the DELFIA assay having the best discriminatory value.

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More information

Published date: June 2005
Keywords: nonparametric, fluorometry, hypertension, endocrinology, comparative study, diagnosis, design, statistics, hyperaldosteronism, urine, congenital, random allocation, methods, mass fragmentography, laboratories, analogs & derivatives, clinical medicine, hydrocortisone, patients, differential, evaluation studies, radioimmunoassay, adrenal hyperplasia, adenoma, humans

Identifiers

Local EPrints ID: 60165
URI: https://eprints.soton.ac.uk/id/eprint/60165
ISSN: 0804-4643
PURE UUID: 3ece3f72-7ac5-49ec-bbc4-439c57242a0c

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Date deposited: 05 Sep 2008
Last modified: 13 Mar 2019 20:29

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