A brief update on mass spectrometry applications to routine clinical endocrinology

Mass spectrometry in clinical laboratories has traditionally focussed on small molecule analysis making endocrinology applications a natural choice given the numerous diagnostic targets in the steroid family, many of which could be multiplexed. Over time, methods for lower abundance steroids were successfully translated meaning that almost all small molecule targets in clinical endocrinology could be performed using mass spectrometry. This has paved the way for standardization efforts which have ultimately forced the improvements in the immunoassay industry. More recently, however improvements in quantitative mass spectrometric protein workflows have permitted the translation of a number of specific protein targets into routine analysis. In addition to the benefits in analytical specificity, judicious selection of peptide targets has permitted simultaneous quantitation and phenotyping in some cases. Mass spectrometry continues to clarify previously unnoticed but significant analytical problems with commercial immunoassays and permits the investigation of interferences in individual patient cases on an ad hoc basis.