Abstract

Contributions of Mass Spectrometry in the Diagnosis and Management of Hypothalamic–pituitary–adrenal Axis Disorders

Gregori Casals, Scientist, Hospital Clínic Barcelona

Mass spectrometry is increasingly used in clinical laboratories for the measurement of steroid hormones. In fact, clinical biochemistry and endocrine societies emphasize in their documents the enhanced analytical specificity for mass spectrometry measurements of steroids in comparison with conventional immunoassays. Thus, the use of high specific methods is recommended. In this regard, mass spectrometry can be useful to overcome many of the limitations of immunoassays, which are mainly but not only due to cross-reactivity with structurally related compounds. The talk will discuss how the improvements in the measurement of glucocorticoids and mineralocorticoids obtainable by well validated mass spectrometry methods are translated into clinical relevant information for the evaluation and management of hypothalamic-pituitary-adrenal axis disorders. Among others, mass spectrometry may be useful to avoid clinical uncertainties derived from immunoassay based results and, at the same time, it allows the obtaining of a more complete view of the steroidogenic status of the patients by means of steroid profiling.