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Falsely elevated serum antimüllerian hormone level in a context of heterophilic interference
Hélène Cappy1, Pascal Pigny, Maryse Leroy-Billiard
1Department of Endocrine Gynecology and Reproductive Medicine, Hôpital Jeanne de Flandre, Centre Hospitalier Régional Universitaire, and Faculty of Medicine of Lille, University of Lille II, Lille, France.
Objective:
To describe a case of falsely elevated serum antimüllerian hormone (AMH) level in an infertile 37-year-old woman with rheumatoid arthritis.
Design:
Case report.
Setting:
Lille University IVF center.
Patient(S):
A 37-year-old woman with rheumatoid arthritis demonstrating a high serum AMH level (74.5 ng/mL) and a low antral follicle count.
Intervention(S):
Assay with a Heterophilic Blocking Tube (HBT) to avoid heterophilic interference.
Main Outcome Measure(S):
Serum AMH level, ultrasound antral follicle count, hormonal assays on the 4th day of a spontaneous cycle.
Result(S):
The results of the infertility workup were as follows: serum AMH: 74.5 ng/mL (15-fold the upper limit of normal) (immunoassay: Immunotech); LH: 3.2 IU/L; FSH: 4.5 IU/L; E2: 27 pg/mL; PRL: 10 ng/mL. The antral follicle count (follicles from 2 to 9 mm) at ultrasound was 7 for both ovaries. Because there were discrepancies between the serum AMH level and the results of the infertility workup using the bioassays, we suspected a case of falsely elevated AMH level due to heterophilic interference. An HBT tube revealed a serum AMH level of 0.63 ng/mL.
Conclusion(S):
This case illustrates, for the first time, the possibility of a falsely high serum AMH level due to heterophilic interference.
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