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A spurious markedly increased serum estradiol level due to an IgA lambda
D L Gordon1, E Holmes, E J Kovacs
1Division of Endocrinology, Department of Medicine, Loyola University Medical Center, Maywood, Illinois, USA.
Objective:
To alert physicians about the potential for erroneous laboratory determinations of hormone levels and emphasize the need to assess the overall clinical situation as well.
Methods:
We present a case report of a woman with a dramatically increased serum estradiol (E(2)) level on radioimmunoassay and review the studies that led to the conclusion that this laboratory finding did not reflect her true estrogen status.
Results:
In a 41-year-old woman, an unnecessary surgical procedure was performed because of a falsely increased serum E(2) level and a unilateral ovarian mass. The markedly increased serum E(2) measured by radioimmunoassay was found to be attributable to an IgA lambda that bound to the 125 I-labeled tracer of the assay.
Conclusion:
When repeatedly abnormal hormone levels and the clinical picture seem discrepant, use of a different assay method should be considered.
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