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Related Experiment Videos

Artifactual elevation of thyroid-stimulating hormone.

J M Wood1, D L Gordon, A N Rudinger

  • 1Department of Medicine, Loyola University Stritch School of Medicine, Maywood, Illinois.

The American Journal of Medicine
|February 1, 1991
PubMed
Summary
This summary is machine-generated.

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A patient with normal thyroid function had falsely high thyroid-stimulating hormone (TSH) levels due to an anti-mouse antibody interfering with the assay. This highlights the importance of considering assay interference in diagnosing thyroid disorders.

Area of Science:

  • Endocrinology
  • Clinical Chemistry
  • Immunology

Background:

  • Thyroid-stimulating hormone (TSH) is a key regulator of thyroid function.
  • Elevated TSH typically indicates primary hypothyroidism, but clinical presentation must be considered.
  • Immunoassays are standard for TSH measurement, but can be subject to interference.

Observation:

  • A clinically euthyroid patient presented with elevated serum TSH by fluoroimmunoassay.
  • TSH levels were unresponsive to thyroid hormone therapy and thyrotropin-releasing hormone (TRH) stimulation.
  • Pituitary imaging and alpha-subunit levels were normal.

Findings:

  • TSH was undetectable using an assay with a sheep antibody.
  • Adding mouse IgG to the fluoroimmunoassay reduced the measured TSH to undetectable levels.

Related Experiment Videos

  • These findings suggest the elevated TSH was an artifact caused by an anti-mouse antibody.

    • Implications:

    • Assay interference, particularly from heterophile antibodies like anti-mouse antibodies, can cause artifactual TSH elevations.
    • Clinicians should consider immunoassay interference when TSH results are discordant with clinical status.
    • Careful interpretation of TSH results in conjunction with clinical context and potentially alternative assay methods is crucial.