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A Dozen Testosterone Samples From One Patient, on One Day?
1Department of Pathology, Kaiser Permanente Northwest, Portland, Oregon.
Laboratory Medicine
|June 16, 2020
Summary
Diagnosing female virilization and infertility is aided by lab tests. Ovarian vein sampling successfully located bilateral androgen production in a patient with elevated testosterone, amenorrhea, and hirsutism.
Area of Science:
- Endocrinology
- Reproductive Medicine
- Medical Diagnostics
Background:
- Female virilization and infertility present diagnostic challenges.
- Routine laboratory testing aids in differential diagnosis.
- Elevated serum testosterone is a key indicator.
Observation:
- A 28-year-old female presented with amenorrhea, hirsutism, and infertility.
- Markedly elevated serum testosterone levels were detected.
- Bilateral ovarian vein sampling was performed for testosterone localization.
Findings:
- Ovarian vein sampling proved diagnostic in localizing ectopic testosterone production.
- Bilateral androgen production was identified in this unique case.
- This highlights the utility of ovarian vein sampling when adrenal vein sampling is insufficient.
Implications:
- Accurate localization of androgen excess is crucial for guiding surgical interventions.
- Interdisciplinary collaboration between clinical laboratories and procedural teams is essential.
- This case expands understanding of rare causes of virilization and infertility.
