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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter / Tate, Jillian R.

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Volume 49, Issue 12


Heterophilic antibody interference in commercial immunoassays; a screening study using paired native and pre-blocked sera

Nils Bolstad / David J. Warren / Johan Bjerner / Gunnhild Kravdal
  • Unit of Medical Biochemistry, Division for Diagnostics and Technology, Akershus University Hospital, Lørenskog, Norway
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Lutz Schwettmann / Kari H. Olsen / Pål Rustad / Kjell Nustad
Published Online: 2011-09-08 | DOI: https://doi.org/10.1515/CCLM.2011.702


Background: Heterophilic antibodies are still an important source of interference in immunoassays. We have conducted a screening study for interference in a panel of commercially available assays using two sera known to contain high titer Fc-reactive heterophilic antibodies.

Methods: The sera were distributed to laboratories participating in the Nordic External Quality Assessment cooperation (EQANord). Duplicate samples pre-blocked with aggregated murine monoclonal MAK33 were also supplied. Discrepancies (>50%) between the results for native and blocked samples were used to classify the tested assays as susceptible to interference. A total of 170 different assay kits covering 91 analytes were tested.

Results: We found that 21 assays, covering 19 different analytes, were susceptible to interference from the heterophilic antibodies in the two sera. Many of these are clinically and commercially important assays. Some of the false results were grossly elevated and could have been detrimental to patient care in a clinical setting.

Conclusions: Heterophilic antibodies with Fc-reactivity remain a threat. A more widespread use of antibody fragments and aggregated immunoglobulin could potentially improve the heterophilic antibody resistance of assays intended for clinical use.

This article offers supplementary material which is provided at the end of the article.

Keywords: HAMAs; heterophile antibody; heterophilic; interference; immunoassay

About the article

Corresponding author: Nils Bolstad, Department of Medical Biochemistry, Oslo University Hospital, Radiumhospitalet, 0310 Oslo, Norway Phone: +47 22935107, Fax: +47 22730725

Received: 2011-06-20

Accepted: 2011-08-05

Published Online: 2011-09-08

Published in Print: 2011-12-01

Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 49, Issue 12, Pages 2001–2006, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2011.702.

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©2011 by Walter de Gruyter Berlin Boston. This content is open access.

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