Hirsutism laboratory findings
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Laboratory tests that should be done in hirsutism include testosterone level, DHEAS, and 24-hour cortisol level.
- Serum testosterone may be normal to increased in case of PCOS and CAH but would be definitely raised (>200 ng/ml) in case of malignant tumor of the adrenal or ovary.
- Dehydroepiandrosterone sulfate (DHEAS): Raised DHEAS (>700 μg/dl) always indicates an adrenal cause, benign or malignant.
- 17 Hydroxy progesterone: Levels less than 200 ng/dl excludes CAH. Mildly increased levels between 300 and 1,000 ng/dl require an ACTH stimulation test. Cosyntropin (synthetic ACTH), 250 μg, is administered intravenously, and levels of 17-hydroxyprogesterone are measured before and one hour after the injection. Post-stimulation values (>1,000 ng/dl) constitute a positive test.
24-hour urinary cortisol
- Twenty four hour urine free cortisol should be measured in women with signs and symptoms of Cushing's syndrome.
- Lin-Su K, Nimkarn S, New MI (2008). "Congenital adrenal hyperplasia in adolescents: diagnosis and management". Ann. N. Y. Acad. Sci. 1135: 95–8. doi:10.1196/annals.1429.021. PMID 18574213.
- Chang RJ, Katz SE (1999). "Diagnosis of polycystic ovary syndrome". Endocrinol. Metab. Clin. North Am. 28 (2): 397–408, vii. PMID 10352925.
- Schmidt JB, Lindmaier A, Spona J (1991). "[Hyperprolactinemia and hypophyseal hypothyroidism as cofactors in hirsutism and androgen-induced alopecia in women]". Hautarzt (in German). 42 (3): 168–72. PMID 1905280.