Heterophile antibody interference affecting multiple Roche immunoassays: A case study

Analysis of many clinically important analytes is dependent on antibody-based assays. However, depending on the design, these assays are vulnerable to interference from endogenous molecules including circulating antibodies and free biotin. In this case report, we describe a patient whose laboratory...

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Bibliographic Details
Published in:Clinica chimica acta 2019-10, Vol.497, p.125-129
Main Authors: Serei, Virian D., Marshall, Ian, Carayannopoulos, Mary O.
Format: Article
Language:English
Subjects:
Adolescent
Antibodies, Heterophile - analysis
Antibodies, Heterophile - immunology
Biotin-streptavidin
Heterophile antibody
Humans
Hyperthyroid
Immunoassay - methods
Immunoassay - standards
Immunoassay interference
Male
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Summary:Analysis of many clinically important analytes is dependent on antibody-based assays. However, depending on the design, these assays are vulnerable to interference from endogenous molecules including circulating antibodies and free biotin. In this case report, we describe a patient whose laboratory findings from immunoassay based methodologies, are inconsistent with the clinical presentation. A 14-year-old male was referred to Pediatric Endocrinology for suspected hyperthyroidism based on critically elevated free thyroxine (fT4) levels although clinical assessment was inconsistent with hyperthyroidism. Because repeat testing was discrepant, Endocrinology questioned the validity of the results prompting consultation with the laboratory to investigate the source of the inconsistent findings. Review of discordant results revealed that fT4 levels measured in laboratories utilizing Roche instrumentation were critically high, while results from laboratories using alternative platforms (i.e. Siemens Centaur) were within normal limits. After a comprehensive evaluation which included testing of paired specimens on multiple platforms, measurement of serially diluted specimens and a formal evaluation for the presence of heterophile antibodies, it was determined that a heterophile antibody interference was the most likely cause of the aberrant results in this patient.
ISSN:0009-8981
1873-3492
DOI:10.1016/j.cca.2019.07.010