MSACL 2023 Abstract

Self-Classified Topic Area(s): Tox / TDM / Endocrine > none > none

Podium Presentation in Steinbeck 3 on Thursday at 14:40 (Chair: Lindsay Bazydlo / Ramisa Fariha)

Expected to be clinically available in 1 to 4 years. Characterization of Adrenocortical Function in Patients with Severe Infections Using Corticotropin-stimulated Serum Steroid Profiles
Michael Vogeser
University Hospital, LMU Munich, Germany

Michael Vogeser, Prof. Dr. med. (Presenter)
University Hospital, LMU Munich

Presenter Bio: Dr. Michael Vogeser, MD, is specialist in Laboratory Medicine and senior physician at the Hospital of the University of the Ludwig-Maximilians-University Munich, Germany (LMU; Institute of Laboratory Medicine). As an Associate Professor he is teaching Clinical Chemistry and Laboratory Medicine. The main scope of his scientific work is the application of mass spectrometric technologies in routine clinical laboratory testing as translational diagnostics. Besides method development in therapeutic drug monitoring and endocrinology a further particular field of his work is quality and risk management in mass spectrometry and in clinical testing in general. Michael has published >240 articles in peer reviewed medical journals. Michael heads the Commission for In Vitro Diagnostics in the German Association of Scientific Medical Societies (AWMF).)

Abstract

INTRODUCTION:
Relative adrenal insufficiency in severe sepsis can be corrected by hydrocortisone treatment. However, it is not yet fully understood which patients will benefit from this or similar measures. Therefore, diagnostic tests are needed to characterize the functional status of the adrenal gland in patients with life-threatening infections.

OBJECTIVES:
Exploring a new diagnostic approach to describe adrenocortical function.

METHODS:
Corticotropin stimulation was performed in patients with sepsis and healthy control subjects. Baseline and stimulated samples were analyzed using an isotope dilution-based LC-MS/MS method for multi-steroid profiling.

RESULTS:
The dynamics of the steroids studied after corticotropin stimulation in healthy and severely ill subjects were complex. A cortisol-to-corticotropin ratio of >32 was associated with an unfavorable outcome.

CONCLUSION:
Serum steroid profiling by LC-MS/MS in samples obtained after corticotropin stimulation allows a differentiated description of adrenocortical function as exemplified in patients with sepsis.

Financial Disclosure

Description	Y/N	Source
Grants	no
Salary	no
Board Member	no	Editorial Board Clinical Chemistry and Laboratory Medicine
Stock	no
Expenses	yes	Roche Diagnostics
IP Royalty	no

Planning to mention or discuss specific products or technology of the company(ies) listed above:
no