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Licensed Unlicensed Requires Authentication Published by De Gruyter May 1, 2009

Spuriously high thyrotropin values due to anti-thyrotropin antibodies in adult patients

  • Eline Verhoye , Annick Van den Bruel , Joris R. Delanghe , Evi Debruyne and Michel R. Langlois

Abstract

Background: Three adult patients presented with unexpectedly high thyrotropin (TSH) concentrations that were discordant with clinical and biochemical findings of euthyroid or hyperthyroid status.

Methods: Antibody interference in the TSH immunoassay (Roche) was investigated by polyethylene glycol (PEG)-pretreatment, heterophilic blocking tube (HBT)-pretreatment, rheumatoid factor (RF) testing, immunofixation, protein A adsorption, and gel filtration chromatography (GFC).

Results: PEG-precipitation yielded <20% recovery of serum TSH, whereas HBT-pretreatment did not decrease TSH test results. RF-testing and immunofixation were negative. Protein A adsorption and GFC demonstrated the presence of TSH-immunoglobulin complexes in serum.

Conclusions: Interference by TSH-immunoglobulin complexes should be ruled out in euthyroid and hyperthyroid patients presenting with inappropriately increased or non-suppressed TSH values.

Clin Chem Lab Med 2009;47:604–6.


Corresponding author: Michel R. Langlois, Department of Clinical Chemistry, AZ St-Jan, Ruddershove 10, 8000 Bruges, Belgium Phone: +32-50-452729, Fax: +32-50-452619,

Received: 2009-1-6
Accepted: 2009-3-10
Published Online: 2009-05-01
Published in Print: 2009-05-01

©2009 by Walter de Gruyter Berlin New York

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