Heterophile antibodies may falsely increase or decrease thyroglobulin measurement in patients with differentiated thyroid carcinoma
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Luca Giovanella
Abstract
Background: To examine the prevalence of significant interference from heterophile antibodies (HAb) in the measurement of serum thyroglobulin (Tg), we evaluated a large cohort of samples from patients with differentiated thyroid carcinoma (DTC).
Methods: Serum Tg measurements were performed in 406 serum samples before and after incubation of each serum sample in heterophile-blocking tubes (HBT) at room temperature for 1 h. We calculated the difference between the original Tg value and the value obtained after HBT treatment. We considered any sample showing an absolute percent difference >3 SD from the mean percent difference as being affected by HAb interference.
Results: We identified five patients (1%) as showing interference from HAb. Of these, three (60%) showed a false positive or falsely increased Tg concentration without any recurrence following clinical work-up; two (40%) showed a false negative or falsely reduced Tg levels, and metastases were detected in both cases by imaging procedures.
Conclusions: HAb may increase as well as reduce the measured Tg in a significant number of patients. A positive HAb interference should be suspected if Tg elevation does not fit the clinical pictures. A negative interference is a more challenging problem because increases in Tg generally occur as the first sign of recurrence of DTC. Therefore, treatment using HBT tubes of all sera referred for Tg measurement should be considered in order to prevent both unwarranted investigations or therapy, and delayed diagnosis of recurrence in patients affected by DTC.
Clin Chem Lab Med 2009;47:952–4.
©2009 by Walter de Gruyter Berlin New York
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Articles in the same Issue
- Editorial
- Hemolysis index: quality indicator or criterion for sample rejection?
- Review
- Neutrophil CD64: a diagnostic marker for infection and sepsis
- Genetics and Molecular Diagnostics
- Chromosome 9p21 polymorphism is associated with myocardial infarction but not with clinical outcome in Han Chinese
- Differential expression of microRNAs in the placentae of Chinese patients with severe pre-eclampsia
- Clinical, biochemical, and genetic analysis of a Korean neonate with hereditary tyrosinemia type 1
- General Clinical Chemistry and Laboratory Medicine
- Multicenter evaluation of the hemolysis index in automated clinical chemistry systems
- Haemolysis index – an estimate of preanalytical quality in primary health care
- Evaluation of the Innovance D-DIMER analytical performance
- Heterophile antibodies may falsely increase or decrease thyroglobulin measurement in patients with differentiated thyroid carcinoma
- Variation of barrier permeability for albumin and immunoglobulin G influx into cerebrospinal fluid
- Anti-citrullinated protein antibody and rheumatoid factor in patients with end-stage renal disease
- Reference Values and Biological Variations
- Quality of interpretative commenting on common clinical chemistry results in the Asia-Pacific region and Africa
- Analysis and interpretation of drug testing results from patients on chronic pain therapy: a clinical laboratory perspective
- Cancer Diagnostics
- HER1-4 protein concentrations in normal breast tissue from breast cancer patients are expressed by the same profile as in the malignant tissue
- Comparison of fifteen immunoassays for the measurement of serum MUC-1/CA 15-3 in breast cancer patients
- Serum levels of matrix metalloproteinase-2 and -9 and conventional tumor markers (CEA and CA 19-9) in patients with colorectal and gastric cancers
- Unstimulated high sensitive thyroglobulin measurement predicts outcome of differentiated thyroid carcinoma
- Relationship of serum antioxidant micronutrients and sociodemographic factors to cervical neoplasia: a case-control study
- Letters to the Editor
- Clinical efficacy of two cardiac troponin I assays
- Impeded centrifugation in plasmocytoma serum
