Errors in the diagnosis of clinical hyperandrogenism in clinical practice using the example of telemedicine consultations «doctor-patient» and «doctor-doctor» at the Endocrinology Research Centre

Hyperandrogenism syndrome (HA) is a large group of endocrine diseases that occur due to various pathogenetic mechanisms, but are united by the principle of similar clinical symptoms due to excessive quantity and/or quality (activity) of male sex hormones in the female body. HA is one of the most common pathologies of the endocrine system in women of reproductive age. Patients with HA seek help from various specialists: cosmetic defects — to a cosmetologist, menstrual irregularities and infertility — to a gynecologist, pediatricians (congenital dysfunction of the adrenal cortex), therapists and endocrinologists  — remote consequences: dyslipidemia, arterial hypertension and carbohydrate metabolism disorders. Testosterone (T) occupies a key position in the hypothalamus-pituitary-gonads system. In women, it is synthesized by the adrenal cortex, ovarian cells, and is also formed in peripheral tissues. Russian clinical diagnostic laboratories have various diagnostic systems for determining all sorts of biochemical parameters and markers. The accuracy and correctness of the  determination depend on the availability of an adequate and accessible method, as well as the characteristics of the woman’s somatic status, for example, the presence of obesity. The emergence and development of modern technology of high-performance liquid chromatography with tandem mass spectrometric detection, which provides high productivity, almost 100% selectivity, the necessary sensitivity and reproducibility, allows using HPLC-MS/MS as a method recommended by clinical guidelines for diagnosing biochemical hyperandrogenism, which allows excluding false diagnoses in routine clinical practice.

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