High-dose biotin therapy leading to false biochemical endocrine profiles: validation of a simple method to overcome biotin interference
-
Marie-Liesse Piketty
,
Dominique Prie
Abstract
Background:
High-dose biotin therapy is beneficial in progressive multiple sclerosis (MS) and is expected to be adopted by a large number of patients. Biotin therapy leads to analytical interference in many immunoassays that utilize streptavidin-biotin capture techniques, yielding skewed results that can mimic various endocrine disorders. We aimed at exploring this interference, to be able to remove biotin and avoid misleading results.
Methods:
We measured free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone (TSH), parathyroid homrone (PTH), 25-hydroxyvitamin D (25OHD), follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, C-peptide, cortisol (Roche Diagnostics assays), biotin and its main metabolites (liquid chromatography tandem mass spectrometry) in 23 plasmas from MS patients and healthy volunteers receiving high-dose biotin, and in 39 biotin-unsupplemented patients, before and after a simple procedure (designated N5) designed to remove biotin by means of streptavidin-coated microparticles. We also assayed fT4, TSH and PTH in the 23 high-biotin plasmas using assays not employing streptavidin-biotin binding.
Results:
The biotin concentration ranged from 31.7 to 1160 µg/L in the 23 high-biotin plasmas samples. After the N5 protocol, the biotin concentration was below the detection limit in all but two samples (8.3 and 27.6 μg/L). Most hormones results were abnormal, but normalized after N5. All results with the alternative methods were normal except two slight PTH elevations. In the 39 biotin-unsupplemented patients, the N5 protocol did not affect the results for any of the hormones, apart from an 8.4% decrease in PTH.
Conclusions:
We confirm that most streptavidin-biotin hormone immunoassays are affected by high biotin concentrations, leading to a risk of misdiagnosis. Our simple neutralization method efficiently suppresses biotin interference.
Acknowledgments
We are grateful to Marie-Helene Novotny for excellent technical assistance, and to Yohann Hervy (Laboratoire Atlanbio) for measurements of biotin and biotin metabolites concentrations.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: FS and DB are employed by MedDAY Pharmaceuticals.
Honorarium: JCS reports lecture fees and/or travel/hotel expenses from DiaSorin, Roche Diagnostics, Abbott, Amgen, Shire, MSD, Lilly, Rottapharm, Meda.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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Supplemental Material:
The online version of this article (DOI: 10.1515/cclm-2016-1183) offers supplementary material, available to authorized users.
©2017 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Editorial
- Biotin interference on immunoassay methods: sporadic cases or hidden epidemic?
- Reviews
- False biochemical diagnosis of hyperthyroidism in streptavidin-biotin-based immunoassays: the problem of biotin intake and related interferences
- Vitamin K plasma levels determination in human health
- Mini Review
- Point-of-care testing INR: an overview
- Opinion Paper
- Could accreditation bodies facilitate the implementation of medical guidelines in laboratories?
- Genetics and Molecular Diagnostics
- QMPSF is sensitive and specific in the detection of NPHP1 heterozygous deletions
- General Clinical Chemistry and Laboratory Medicine
- High-dose biotin therapy leading to false biochemical endocrine profiles: validation of a simple method to overcome biotin interference
- Multicenter performance evaluation of a second generation cortisol assay
- A rapid UPLC-MS/MS assay for the simultaneous measurement of fluconazole, voriconazole, posaconazole, itraconazole, and hydroxyitraconazole concentrations in serum
- A microplate assay to measure classical and alternative complement activity
- Serological diagnosis and prognosis of severe acute pancreatitis by analysis of serum glycoprotein 2
- Retrospective evaluation of the clinical utility of serological biomarkers in Chinese patients with inflammatory bowel disease: 2-year clinical experience
- Infrared analysis of lipoproteins in the detection of alcohol biomarkers
- Coexistence of anti-β2-glycoprotein I domain I and anti-phosphatidylserine/prothrombin antibodies suggests strong thrombotic risk
- Antiphosphatidylserine/prothrombin antibodies as biomarkers to identify severe primary antiphospholipid syndrome
- Cardiovascular Diseases
- The impact of admission neutrophil-to-platelet ratio on in-hospital and long-term mortality in patients with infective endocarditis
- Letters to the Editor
- Biotin interference in immunoassays mimicking subclinical Graves’ disease and hyperestrogenism: a case series
- A simple method to detect biotin interference on immunoassays
- Proposed classification for a variant of Kounis syndrome
- Lyophilized hemoglobin E control material for the dichlorophenol-indophenol (DCIP) test
- Procalcitonin variation before and after 100-km ultramarathon
- Preliminary study in specific activity of molecular components in allergy: implications for diagnostics and relationship with disease severity
- A 2-min at 4500 g rather than a 15-min at 2200 g centrifugation does not impact the reliability of 10 critical coagulation assays
- Immunoassay interference caused by heterophilic antibodies interacting with biotin
- Red blood cell distribution width and mean platelet volume are potential prognostic indices for patients with primary biliary cirrhosis
- Neutrophil CD64 molecule expression can predict bloodstream infection in septic shock patients
Artikel in diesem Heft
- Frontmatter
- Editorial
- Biotin interference on immunoassay methods: sporadic cases or hidden epidemic?
- Reviews
- False biochemical diagnosis of hyperthyroidism in streptavidin-biotin-based immunoassays: the problem of biotin intake and related interferences
- Vitamin K plasma levels determination in human health
- Mini Review
- Point-of-care testing INR: an overview
- Opinion Paper
- Could accreditation bodies facilitate the implementation of medical guidelines in laboratories?
- Genetics and Molecular Diagnostics
- QMPSF is sensitive and specific in the detection of NPHP1 heterozygous deletions
- General Clinical Chemistry and Laboratory Medicine
- High-dose biotin therapy leading to false biochemical endocrine profiles: validation of a simple method to overcome biotin interference
- Multicenter performance evaluation of a second generation cortisol assay
- A rapid UPLC-MS/MS assay for the simultaneous measurement of fluconazole, voriconazole, posaconazole, itraconazole, and hydroxyitraconazole concentrations in serum
- A microplate assay to measure classical and alternative complement activity
- Serological diagnosis and prognosis of severe acute pancreatitis by analysis of serum glycoprotein 2
- Retrospective evaluation of the clinical utility of serological biomarkers in Chinese patients with inflammatory bowel disease: 2-year clinical experience
- Infrared analysis of lipoproteins in the detection of alcohol biomarkers
- Coexistence of anti-β2-glycoprotein I domain I and anti-phosphatidylserine/prothrombin antibodies suggests strong thrombotic risk
- Antiphosphatidylserine/prothrombin antibodies as biomarkers to identify severe primary antiphospholipid syndrome
- Cardiovascular Diseases
- The impact of admission neutrophil-to-platelet ratio on in-hospital and long-term mortality in patients with infective endocarditis
- Letters to the Editor
- Biotin interference in immunoassays mimicking subclinical Graves’ disease and hyperestrogenism: a case series
- A simple method to detect biotin interference on immunoassays
- Proposed classification for a variant of Kounis syndrome
- Lyophilized hemoglobin E control material for the dichlorophenol-indophenol (DCIP) test
- Procalcitonin variation before and after 100-km ultramarathon
- Preliminary study in specific activity of molecular components in allergy: implications for diagnostics and relationship with disease severity
- A 2-min at 4500 g rather than a 15-min at 2200 g centrifugation does not impact the reliability of 10 critical coagulation assays
- Immunoassay interference caused by heterophilic antibodies interacting with biotin
- Red blood cell distribution width and mean platelet volume are potential prognostic indices for patients with primary biliary cirrhosis
- Neutrophil CD64 molecule expression can predict bloodstream infection in septic shock patients
