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Decreased SHBG levels are often found in hirsutism, acne vilgaris and the polycystic ovary syndrome . SHBG levels in late pregnancy or after estrogen administration may especially elevated. Administration of androgens tends to be associated with decreased SHBG levels. Since variation in the carrier protein levels may effect the concentration of testosterone in circulation, SHBG levels are commonly measured as a supplement to total testosterone determinations. The “free androgen index”(FAI), calculated as the ratio of total testosterone to SHBG, has proved to be a useful indicator of abnormal androgen status in conditions such as hirsutism. SHBG levels may be modestly reduced in hypothyroidism, acromegaly, cushing’s disease and hyperprolactinema. SHBG also tends to be suppressed in obesity and after the administration of androgens notably testosterone, or drugs, like danazol, which complete with androgens for binding sites in SHBG. Glucocorticoids and growth hormone have likewise been associated with decreased SHBG levels. Elevated SHBG may be encountered in hyperthyroidism and hepatic cirrhosis. high levels are also found in a variety of other conditions. Such as pregnancy.Increases may sometimes be seen after the administration of estrogens-e.g. in the form of certain types of oral contraceptives or as a consequence of helatic enzyme induction by drugs such as phenytoin. The use of dexamethasone in the treatment of womrn with hyperandrogetic hirsutism typically leads to an increase in SHBG concentration.
Increased levels may be seen in lymphoproliferative diseases as multiple myeloma, B-cell chronic lymphocytic leukemia, hodgkin’s disease, non-hodgkin’s lymphoma;systemic lupus erythemtosus; rheumataoid arthritis; ajoren’s syndrome; crohn’s disease; and certain viral infection, including cytomegalovirus, non-A and non-B Hepatits and infectious mononucleosis. Elevated serum levels have also been observed in some hemodialysis patient and in renal transplant
Measurement of B2m is considered a sensitive means for diagnosing proximal tubular dysfunction. It is reportedly the most reliable test for distinguishing upper from lower urinary tract infections.
Increased urinary excretion of B2M has been observed ina wide variety of conditions including Wilson’s disease, Fanconi’s syndrome, untreated congenital galactosemia, nephritis, connective-tissue disease such as rheumatoid arthritis and sjoren’s syndrome, occupational exposure to heavy metals such as cadmium and mercury. Upper urinary tract infection. Kindney transplantation. And nephrotoxicity resulting from cyclosporine. Aminoglycoside or cis-platinum therapy.
Volume required : 5 mirco serum or urine.(sample cup must contain at least 100ml more than the total volume required.)
Special Instructions for urine collection : first void the urinary bladder, then drink a large glass of water and collect a urine sample within 1hours.