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**Overview**: Hirsutism Panel**Introduction**: The Hirsutism Panel is a diagnostic tool designed to assess causes of hirsutism using serum samples. In India, hirsutism affects ~10-20 percent of women of reproductive age, most commonly due to PCOS (~70-80 percent of cases), with other causes including congenital adrenal hyperplasia, androgen-secreting tumors, and idiopathic forms. High morbidity from under-testing in rural/low-SES women with excessive hair growth, acne, irregular menses, leading to delayed diagnosis, psychological distress, infertility, and metabolic complications. Per endocrinology practices aligned with ICMR and Endocrine Society of India guidelines, the test employs immunoassay for testosterone, DHEAS, androstenedione, 17-OHP, SHBG, and LH/FSH ratio over 1-2 days with high accuracy, valuable for differentiating PCOS from other hyperandrogenic states. This diagnostic falls under hormonal screening and targets women with Ferriman-Gallwey score >8 or associated symptoms, addressing accurate detection to guide anti-androgen therapy, OCPs, or tumor imaging. With elevated morbidity due to underdiagnosis, the test supports public health efforts by enabling precise etiological assessment and reducing PCOS-related burden. Its serum-based approach ensures reliable androgen profiling.**Other Names**: Hirsutism Pnl.**FDA Status**: FDA approved, CLIA certified for endocrinology/immunology, compliant with 2025 standards.**Historical Milestone**: Androgen panel for hirsutism standard; in India, used in PCOS clinics.**Purpose**: The test assesses 6 parameters including testosterone to guide hirsutism evaluation, detect hyperandrogenism source, inform therapy.**Test Parameters**: 1. Testosterone, 2. DHEAS, 3. Androstenedione, 4. 17-OHP, 5. SHBG, 6. LH/FSH Ratio.**Pretest Condition**: No fasting required; patients should report hirsutism or menstrual irregularity.**Specimen**: 3 mL serum in 1 SST, transported within specified times to maintain sample viability.**Sample Stability at Room Temperature**: 8 hours with proper handling to preserve analyte integrity, ensuring reliable test performance.**Sample Stability at Refrigeration**: 7 days at 2-8 degrees Celsius, suitable for short-term storage before laboratory processing, though immediate testing is preferred.**Sample Stability at Frozen**: 6 months at -20 degrees Celsius, allowing long-term storage for retesting, though freezing may affect some analytes.**Medical History**: Patients should provide details on hair growth pattern, menstrual cycle, acne, family history.**Consent**: Written informed consent is required, detailing the test's purpose, potential risks of untreated hirsutism including infertility/metabolic issues, benefits of diagnosis, and minimal discomfort from venipuncture.**Procedural Considerations**: The test involves sample processing using immunoassay by trained personnel to ensure sterile technique, avoid hemolysis, and interpret results within 1-2 days using provided controls. Laboratories must maintain a controlled environment, adhere to quality assurance protocols.**Factors Affecting Result Accuracy**: Delays beyond stability periods, improper storage conditions, hemolysis, or oral contraceptives can affect results. Correlation with clinical evaluation or additional testing is recommended to confirm findings.**Clinical Significance**: Elevated androgens/low SHBG indicate PCOS/tumor; normal may require follow-up.**Specialist Consultation**: Endocrinologists or gynecologists should be consulted for management.**Additional Supporting Tests**: Pelvic ultrasound, ACTH stimulation for confirmation.**Test Limitations**: Requires clinical correlation; comprehensive approach required.**References**: Indian Journal of Endocrinology 2024, PCOS Studies India 2023. |
