Spurious hypercalcitoninemia and heterophilic antibodies in patients with thyroid nodules

Background The purpose of our study was to examine the prevalence of significant heterophilic antibody (HAb) interferences in serum calcitonin measurement in a large cohort of patients with thyroid nodules. Methods Enrolled in the study were 378 patients with thyroid nodules shown not to have medull...

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Bibliographic Details
Published in:Head & neck 2011-01, Vol.33 (1), p.95-97
Main Authors: Giovanella, Luca, Suriano, Sergio
Format: Article
Language:English
Subjects:
Antibodies, Heterophile - blood
Antibodies, Heterophile - metabolism
Biological and medical sciences
Biomarkers, Tumor - blood
Biopsy, Needle
calcitonin
Calcitonin - blood
Calcitonin - metabolism
Carcinoma, Neuroendocrine
Cohort Studies
Diagnosis, Differential
Endocrinopathies
False Positive Reactions
Female
heterophilic antibodies
Humans
Immunohistochemistry
Male
Malignant tumors
Medical sciences
medullary thyroid carcinoma
Non tumoral diseases. Target tissue resistance. Benign neoplasms
Otorhinolaryngology. Stomatology
Sensitivity and Specificity
Thyroid Neoplasms - blood
Thyroid Neoplasms - diagnosis
Thyroid Neoplasms - immunology
Thyroid Nodule - blood
Thyroid Nodule - diagnosis
Thyroid Nodule - immunology
Thyroid Nodule - surgery
Thyroid. Thyroid axis (diseases)
Thyroidectomy - methods
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Summary:Background The purpose of our study was to examine the prevalence of significant heterophilic antibody (HAb) interferences in serum calcitonin measurement in a large cohort of patients with thyroid nodules. Methods Enrolled in the study were 378 patients with thyroid nodules shown not to have medullary thyroid carcinoma (MTC) after extensive diagnostic workup. Serum calcitonin measurement was performed before and after incubating each serum sample in heterophilic‐blocking tubes (HBTs) and the differences were calculated. Samples showing an absolute percentage difference greater than 3 SD from the mean percentage difference were considered as affected by heterophilic antibody interference. Results Five of 378 patients (1.3%) with HAb interferences were identified, 4 with clinically relevant false‐positive calcitonin results. Conclusion A false‐positive calcitonin result due to HAb interference occurs more frequently than MTC (1.3% vs 0%) in our patient series. A serum pretreatment in HBTs should be considered when increased serum calcitonin levels are found in a patient with a thyroid nodule to prevent unwarranted investigations or therapies. © 2010 Wiley Periodicals, Inc. Head Neck, 2011
ISSN:1043-3074
1097-0347
DOI:10.1002/hed.21405