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Related Experiment Video

Updated: Jun 5, 2026

Generation of Hypoparathyroid Rats via Carbon-Nanoparticle-Assisted Parathyroidectomy

Generation of Hypoparathyroid Rats via Carbon-Nanoparticle-Assisted Parathyroidectomy

Published on: July 14, 2023

Falsely elevated plasma parathyroid hormone level mimicking tertiary hyperparathyroidism.

Olga Levin¹, Lilah F Morris, David T Wah

¹Endocrine Surgical Unit, Department of General Surgery, David Geffen School of Medicine, University of California at Los Angeles, CA, USA.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists

|January 21, 2011

Summary

Heterophile antibodies can interfere with parathyroid hormone (PTH) assays, leading to misdiagnosis of tertiary hyperparathyroidism. This case highlights the importance of considering antibody interference when PTH levels are inconsistent with clinical presentation.

Related Experiment Videos

Last Updated: Jun 5, 2026

Generation of Hypoparathyroid Rats via Carbon-Nanoparticle-Assisted Parathyroidectomy

Generation of Hypoparathyroid Rats via Carbon-Nanoparticle-Assisted Parathyroidectomy

Published on: July 14, 2023

Area of Science:

Clinical Chemistry
Endocrinology
Immunology

Background:

Tertiary hyperparathyroidism can be challenging to diagnose and manage, particularly in patients with comorbidities like renal allografts.
Parathyroid hormone (PTH) assays are crucial for diagnosing and monitoring hyperparathyroidism, but can be subject to interference.

Observation:

A patient with a functioning renal allograft presented with markedly elevated PTH levels, refractory to medical therapy, and underwent parathyroidectomy.
Postoperatively, PTH levels remained high, and the patient developed severe hypocalcemia, suggesting a discrepancy between assay results and clinical status.

Findings:

Reanalysis using a heterophile blocking agent and a different immunoassay revealed the true PTH level was significantly lower (5 pg/mL), indicating a falsely elevated result.
The elevated PTH was attributed to human antimurine heterophile antibodies, likely induced by prior administration of muromonab-CD3 (Orthoclone OKT3).

Implications:

This case underscores the critical need to recognize heterophile antibody interference in immunoassays, especially in patients receiving murine-derived therapies.
Accurate PTH measurement is essential for appropriate clinical management, preventing unnecessary interventions and potential complications like severe hypocalcemia.