Measurement of Late-Night Salivary Cortisol and Cortisone by LC-MS/MS to Assess Preanalytical Sample Contamination with Topical Hydrocortisone

Raff, Hershel; Singh, Ravinder J.

doi:10.1373/clinchem.2012.182717

Cited by 48 publications

(50 citation statements)

References 5 publications

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“…This was further investigated by Raff (30) who also found that dramatically increased salivary cortisol value by IA could be caused by cortisol contamination. In these cases, contamination with topical hydrocortisone was suggested by a normal salivary cortisone concentration as measured by LC-MS/MS and a high cortisol-to-cortisone ratio (31).…”

Section: Commonly Requested Steroidsmentioning

confidence: 99%

Mass spectrometry and immunoassay: how to measure steroid hormones today and tomorrow

Taylor¹,

Keevil²,

Huhtaniemi³

2015

European Journal of Endocrinology

260

157

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SummaryThe recent onslaught of mass spectrometry (MS) to measurements of steroid hormones, including demands that they should be the only acceptable method, has confused clinicians and scientists who have relied for more than 40 years on a variety of immunoassay (IA) methods in steroid hormone measurements. There is little doubt that MS methods with their superior specificity will be the future method of choice in many clinical and research applications of steroid hormone measurement. However, the majority of steroid measurements are currently, and will continue to be, carried out using various types of IAs for several reasons, including their technical ease, cost and availability of commercial reagents. Speedy replacement of all IAs with MS is an unrealistic and unnecessary goal, because the availability of MS measurements is limited by cost, need of expensive equipment, technical demands and lack of commercial applications. Furthermore, IAs have multiple well-known advantages that vindicate their continuing use. The purpose of this article is to elucidate the advantages and limitations of the MS and IA techniques from two angles, i.e. promotion of MS and defence of IA. The purpose of the text is to give the reader an unbiased view about the current state and future trends of steroid analysis and to help him/her choose the correct assay method to serve his/her diagnostic and research needs.

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Section: Commonly Requested Steroidsmentioning

confidence: 99%

Mass spectrometry and immunoassay: how to measure steroid hormones today and tomorrow

Taylor¹,

Keevil²,

Huhtaniemi³

2015

European Journal of Endocrinology

260

157

View full text Add to dashboard Cite

show abstract

“…Therefore, some authors have advocated using this test as a first method of screening (33,(56)(57)(58).…”

Section: Late-night Salivary Cortisolmentioning

confidence: 99%

“…As with any method, false negatives and most especially false positives can occur in individuals with an altered sleep-wake cycle, psychiatric disorders, uncontrolled diabetes mellitus, and oral/gum disease (blood contamination) and in the elderly (27,37,55); additionally, extremely high results can be due to contamination with corticosteroids in skin creams (57). In addition, it is recommended not to smoke 24 h before collection due to glycyrrhizic acid (derived from licorice), which inhibits the 11β-HSD2 salivary enzyme.…”

Section: Late-night Salivary Cortisolmentioning

confidence: 99%

“…As an alternative, late-night salivary cortisol can be used, but it has shown less sensitivity when compared to the low-dose dexamethasone suppression test in this subgroup of patients (57,(110)(111)(112)(113). Finally, with regard to first-line methods, 24-h UFC is the method with the highest number of false negative results, as it is diagnostic only when the disease is overt.…”

Section: Adrenal Incidentalomamentioning

confidence: 99%

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Recommendations of the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism for the diagnosis of Cushing’s disease in Brazil

Machado

Fragoso

Moreira

et al. 2016

Arch. Endocrinol. Metab.

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Although it is a rare condition, the accurate diagnosis and treatment of Cushing's disease is important due to its higher morbidity and mortality compared to the general population, which is attributed to cardiovascular diseases, diabetes mellitus and infections. Screening for hypercortisolism is recommended for patients who present multiple and progressive clinical signs and symptoms, especially those who are considered to be more specific to Cushing's syndrome, abnormal findings relative to age (e.g., spinal osteoporosis and high blood pressure in young patients), weight gain associated with reduced growth rate in the pediatric population and for those with adrenal incidentalomas. Routine screening is not recommended for other groups of patients, such as those with obesity or diabetes mellitus. Magnetic resonance imaging (MRI) of the pituitary, the corticotropin-releasing hormone (CRH) test and the high-dose dexamethasone suppression test are the main tests for the differential diagnosis of ACTH-dependent Cushing's syndrome. Bilateral and simultaneous petrosal sinus sampling is the gold standard method and is performed when the triad of initial tests is inconclusive, doubtful or conflicting. The aim of this article is to provide information on the early detection and establishment of a proper diagnosis of Cushing's disease, recommending follow-up of these patients at experienced referral centers. Arch Endocrinol Metab. 2016;60(3):267-86

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“…It may be that over-thecounter hydrocortisone creams and ointments (containing authentic cortisol) are not widely available or used in Russia or Chile. Regardless, this is a significant issue in the United States that can be resolved by demonstrating a lack of increased salivary cortisone measured by LC-MS/MS [12].…”

mentioning

confidence: 99%

Salivary cortisol and the diagnosis of Cushing’s syndrome: a coming of age

Raff

2012

Endocrine

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Measurement of Late-Night Salivary Cortisol and Cortisone by LC-MS/MS to Assess Preanalytical Sample Contamination with Topical Hydrocortisone

Abstract: Hospital for providing some of the samples for this study, and Bio-Rad Laboratories for providing the Hb A 1c analyses for their methods.

Cited by 48 publications

References 5 publications

Mass spectrometry and immunoassay: how to measure steroid hormones today and tomorrow

Mass spectrometry and immunoassay: how to measure steroid hormones today and tomorrow

Recommendations of the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism for the diagnosis of Cushing’s disease in Brazil

Salivary cortisol and the diagnosis of Cushing’s syndrome: a coming of age

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