If "androgens" or "androgen screen" is requested, a testosterone will be performed.
This test may be vetted by a pathologist.
The clinical information for the test must be clearly written on the request form. If clinical information is not provided, or does not provide sufficient justification for the test, the test may be declined.
Declined tests :
If a test is declined, the specimen will be held for a reasonable period (usually 3 weeks but dependant on the stability of the sample). Medical practitioners seeking approval for a declined test should email the on-call Chemical Pathologist ( chemicalpathologist@adhb.govt.nz ) , giving the patient's name and NHI number and the clinical justification for the test. If unable to email, call the on-call Chemical Pathologist via Lablink (09-3078995) and identify yourself as a doctor.
Refer to Testosterone for the appropriate reference intervals.
Investigation of hirsutism /PCOS
Testosterone is the main androgen in both males and females, and is the key andogen to measure in investigation of hirsutism / PCOS.
If testosterone is normal, hyperandrogenism is excluded and it is not necessary to measure DHEAS or androstenedione.
DHEA and androstenedione are testosterone precursors, which may be secreted by adrenal or ovarian tumours.
Although DHEAS and androstenedione are commonly elevated in PCOS and idiopathic hyperandrogenism, their measurement adds no diagnostic value over testosterone in these conditions.
The diagnostic use of DHEAS and androstenedione is in the diagnosis and monitoring of
congenital adrenal hyperplasia
, and
androgen secreting tumours of ovary and adrenal
.
If the testosterone level is normal, requests for DHEAS or androstenedione may be declined by the pathologist.
Reference
Martin, K. A., R. J. Chang, et al. (2008). "Evaluation and treatment of hirsutism in premenopausal women: an endocrine society clinical practice guideline." J Clin Endocrinol Metab 93(4): 1105-1120.
Emails to chemicalpathologist@adhb.govt.nz will receive priority attention from the on-call chemical pathologist.
If the query concerns a specific patient please include the NHI number in your email.
If email is not a suitable option, please contact the on-call chemical pathologist via Lablink (Auckland City Hospital ext. 22000 or 09-3078995).
Individual chemical pathologists may be contacted but will not be available at all times.
After-hours : contact Lablink (Auckland City Hospital ext. 22000 or 09-3078995) or hospital operator for on duty staff after hours.
Dr Samarina Musaad (Clinical Lead) : SamarinaM@adhb.govt.nz ext. 22402
Dr Cam Kyle: CampbellK@adhb.govt.nz ext 22052
Dr Weldon Chiu: WeldonC@adhb.govt.nz ext. 23427
Dr Campbell Heron: CHeron@adhb.govt.nz ext. 23427
Dr Sakunthala Jayasinghe: Sakunthala@adhb.govt.nz ext. 23427