Home Medicine Anti-streptavidin IgG antibody interference in anti-cyclic citrullinated peptide (CCP) IgG antibody assays is a rare but important cause of false-positive anti-CCP results
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Anti-streptavidin IgG antibody interference in anti-cyclic citrullinated peptide (CCP) IgG antibody assays is a rare but important cause of false-positive anti-CCP results

  • Mario Berth EMAIL logo , Sofie Willaert and Carol De Ridder
Published/Copyright: February 21, 2018
Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 56 Issue 8

Abstract

Background:

The detection of anti-cyclic citrullinated peptide (anti-CCP) IgG antibodies in blood is mainly used for the diagnosis of rheumatoid arthritis. Falsely elevated anti-CCP IgG antibodies due to anti-streptavidin IgG antibodies were suspected in our laboratory.

Methods:

In this study, we evaluated, in a standardized approach, the prevalence of anti-streptavidin IgG antibodies in a primary care setting and the effect of anti-streptavidin IgG antibodies on anti-CCP IgG assays from three different important commercial manufacturers (Abbott, Roche Diagnostics, Thermo Fisher Scientific). Three different populations were consecutively and prospectively studied: serum samples from 1000 ambulatory patients, 286 serum samples from patients for which anti-CCP was requested and 89 serum samples from patients which had previously given a positive anti-CCP result on Architect® i2000.

Results:

The frequency of confirmed anti-streptavidin IgG-positive samples detected in this study was 0.6% (8/1375). Anti-CCP IgG was determined on the eight samples with confirmed anti-streptavidin IgG antibodies: with the Cobas® method, seven positive anti-CCP results were observed and five positive anti-CCP results with the Architect® method. No positive anti-CCP IgG results were obtained with the EliA™ method. Rheumatoid factor was negative in these eight samples.

Conclusions:

Anti-streptavidin IgG antibodies rarely cause false-positive results in some anti-CCP assays. However, despite being an infrequent assay problem, it could possibly lead to diagnostic confusion or even an incorrect diagnosis of rheumatoid arthritis.

Keywords: anti-CCP; false-positive results; immunoglobulins; interference; rheumatoid arthritis; streptavidin
Corresponding author: Dr. Mario Berth, Algemeen Medisch Laboratorium (AML), Sonic Healthcare, Emiel Vloorsstraat 9, 2020 Antwerpen, Belgium, Phone: +32 3 30 30 800, Fax: +32 3 30 30 880

Acknowledgments

We would like to thank Thermo Fisher Scientific – Phadia for donating the anti-CCP IgG and anti-streptavidin IgG screening assay reagents used on Phadia 250.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. 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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Received: 2017-12-11
Accepted: 2018-01-24
Published Online: 2018-02-21
Published in Print: 2018-07-26

©2018 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Editorials
  3. Procalcitonin for diagnosing and monitoring bacterial infections: for or against?
  4. Is it time to abandon the Nobel Prize?
  5. In Memoriam
  6. Norbert Tietz, 13th November 1926–23rd May 2018
  7. Reviews
  8. Procalcitonin guidance in patients with lower respiratory tract infections: a systematic review and meta-analysis
  9. Telomere biology and age-related diseases
  10. Opinion Paper
  11. Procalcitonin-guided antibiotic therapy: an expert consensus
  12. Genetics and Molecular Diagnostics
  13. mRNA expression profile in peripheral blood mononuclear cells based on ADRB1 Ser49Gly and Arg389Gly polymorphisms in essential hypertension — a case-control pilot investigation in South Indian population
  14. General Clinical Chemistry and Laboratory Medicine
  15. External quality assessment schemes for glucose measurements in Germany: factors for successful participation, analytical performance and medical impact
  16. Long-term stability of glucose: glycolysis inhibitor vs. gel barrier tubes
  17. Observational studies on macroprolactin in a routine clinical laboratory
  18. Anti-streptavidin IgG antibody interference in anti-cyclic citrullinated peptide (CCP) IgG antibody assays is a rare but important cause of false-positive anti-CCP results
  19. Point-of-care creatinine testing for kidney function measurement prior to contrast-enhanced diagnostic imaging: evaluation of the performance of three systems for clinical utility
  20. Hematology and Coagulation
  21. Analytical performance of an automated volumetric flow cytometer for quantitation of T, B and natural killer lymphocytes
  22. Lupus anticoagulant testing using two parallel methods detects additional cases and predicts persistent positivity
  23. Reference Values and Biological Variations
  24. Within-subject biological variation of activated partial thromboplastin time, prothrombin time, fibrinogen, factor VIII and von Willebrand factor in pregnant women
  25. Within-subject and between-subject biological variation estimates of 21 hematological parameters in 30 healthy subjects
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  27. Cancer Diagnostics
  28. Serum carbohydrate sulfotransferase 7 in lung cancer and non-malignant pulmonary inflammations
  29. Cardiovascular Diseases
  30. Clinical performance of a new point-of-care cardiac troponin I test
  31. Diabetes
  32. Testing for HbA1c, in addition to the oral glucose tolerance test, in screening for abnormal glucose regulation helps to reveal patients with early β-cell function impairment
  33. Effects of common hemoglobin variants on HbA1c measurements in China: results for α- and β-globin variants measured by six methods
  34. Infectious Diseases
  35. Serum procalcitonin concentration within 2 days postoperatively accurately predicts outcome after liver resection
  36. Predictive value of serum gelsolin and Gc globulin in sepsis – a pilot study
  37. Cerebrospinal fluid free light chains as diagnostic biomarker in neuroborreliosis
  38. Letter to the Editor
  39. Glucose and total protein: unacceptable interference on Jaffe creatinine assays in patients
  40. Interference of glucose and total protein on Jaffe-based creatinine methods: mind the covolume
  41. Interference of glucose and total protein on Jaffe based creatinine methods: mind the covolume – reply
  42. Measuring procalcitonin to overcome heterophilic-antibody-induced spurious hypercalcitoninemia
  43. Paraprotein interference in the diagnosis of hepatitis C infection
  44. Timeo apis mellifera and dona ferens: bee sting-induced Kounis syndrome
  45. Bacterial contamination of reusable venipuncture tourniquets in tertiary-care hospital
  46. Detection of EDTA-induced pseudo-leukopenia using automated hematology analyzer with VCS technology
  47. Early adjustment of antimicrobial therapy after PCR/electrospray ionization mass spectrometry-based pathogen detection in critically ill patients with suspected sepsis
  48. Thromboelastometry reveals similar hemostatic properties of purified fibrinogen and a mixture of purified cryoprecipitate protein components
  49. Bicarbonate interference on cobas 6000 c501 chloride ion-selective electrodes
https://doi.org/10.1515/cclm-2017-1153
Keywords for this article
anti-CCP; false-positive results; immunoglobulins; interference; rheumatoid arthritis; streptavidin

Articles in the same Issue

  1. Frontmatter
  2. Editorials
  3. Procalcitonin for diagnosing and monitoring bacterial infections: for or against?
  4. Is it time to abandon the Nobel Prize?
  5. In Memoriam
  6. Norbert Tietz, 13th November 1926–23rd May 2018
  7. Reviews
  8. Procalcitonin guidance in patients with lower respiratory tract infections: a systematic review and meta-analysis
  9. Telomere biology and age-related diseases
  10. Opinion Paper
  11. Procalcitonin-guided antibiotic therapy: an expert consensus
  12. Genetics and Molecular Diagnostics
  13. mRNA expression profile in peripheral blood mononuclear cells based on ADRB1 Ser49Gly and Arg389Gly polymorphisms in essential hypertension — a case-control pilot investigation in South Indian population
  14. General Clinical Chemistry and Laboratory Medicine
  15. External quality assessment schemes for glucose measurements in Germany: factors for successful participation, analytical performance and medical impact
  16. Long-term stability of glucose: glycolysis inhibitor vs. gel barrier tubes
  17. Observational studies on macroprolactin in a routine clinical laboratory
  18. Anti-streptavidin IgG antibody interference in anti-cyclic citrullinated peptide (CCP) IgG antibody assays is a rare but important cause of false-positive anti-CCP results
  19. Point-of-care creatinine testing for kidney function measurement prior to contrast-enhanced diagnostic imaging: evaluation of the performance of three systems for clinical utility
  20. Hematology and Coagulation
  21. Analytical performance of an automated volumetric flow cytometer for quantitation of T, B and natural killer lymphocytes
  22. Lupus anticoagulant testing using two parallel methods detects additional cases and predicts persistent positivity
  23. Reference Values and Biological Variations
  24. Within-subject biological variation of activated partial thromboplastin time, prothrombin time, fibrinogen, factor VIII and von Willebrand factor in pregnant women
  25. Within-subject and between-subject biological variation estimates of 21 hematological parameters in 30 healthy subjects
  26. Immunoglobulin G (IgG) and IgG subclass reference intervals in children, using Optilite® reagents
  27. Cancer Diagnostics
  28. Serum carbohydrate sulfotransferase 7 in lung cancer and non-malignant pulmonary inflammations
  29. Cardiovascular Diseases
  30. Clinical performance of a new point-of-care cardiac troponin I test
  31. Diabetes
  32. Testing for HbA1c, in addition to the oral glucose tolerance test, in screening for abnormal glucose regulation helps to reveal patients with early β-cell function impairment
  33. Effects of common hemoglobin variants on HbA1c measurements in China: results for α- and β-globin variants measured by six methods
  34. Infectious Diseases
  35. Serum procalcitonin concentration within 2 days postoperatively accurately predicts outcome after liver resection
  36. Predictive value of serum gelsolin and Gc globulin in sepsis – a pilot study
  37. Cerebrospinal fluid free light chains as diagnostic biomarker in neuroborreliosis
  38. Letter to the Editor
  39. Glucose and total protein: unacceptable interference on Jaffe creatinine assays in patients
  40. Interference of glucose and total protein on Jaffe-based creatinine methods: mind the covolume
  41. Interference of glucose and total protein on Jaffe based creatinine methods: mind the covolume – reply
  42. Measuring procalcitonin to overcome heterophilic-antibody-induced spurious hypercalcitoninemia
  43. Paraprotein interference in the diagnosis of hepatitis C infection
  44. Timeo apis mellifera and dona ferens: bee sting-induced Kounis syndrome
  45. Bacterial contamination of reusable venipuncture tourniquets in tertiary-care hospital
  46. Detection of EDTA-induced pseudo-leukopenia using automated hematology analyzer with VCS technology
  47. Early adjustment of antimicrobial therapy after PCR/electrospray ionization mass spectrometry-based pathogen detection in critically ill patients with suspected sepsis
  48. Thromboelastometry reveals similar hemostatic properties of purified fibrinogen and a mixture of purified cryoprecipitate protein components
  49. Bicarbonate interference on cobas 6000 c501 chloride ion-selective electrodes
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