Contributions of Mass Spectrometry in the Diagnosis and Management of Hypothalamic–pituitary–adrenal Axis Disorders

Mass spectrometry can be useful to overcome many of the limitations of immunoassays, which are mainly but not only due to cross-reactivity with structurally related compounds. The talk will discuss how the improvements in the measurement of glucocorticoids and mineralocorticoids obtainable by well validated mass spectrometry methods are translated into clinical relevant information for the evaluation and management of hypothalamic-pituitary-adrenal axis disorders. Among others, mass spectrometry may be useful to avoid clinical uncertainties derived from immunoassay based results and, at the same time, it allows the obtaining of a more complete view of the steroidogenic status of the patients by means of steroid profiling.