Cardiac troponin T quantitative assay failure as a result of antibody interference
Philip H Fortgens1,2, Fierdoz Omar1,2
1Department of Clinical Laboratory Sciences, Division of Chemical Pathology, University of Cape Town, South Africa.
Background:
Immunoassays are prone to interference by various substances which may cause inaccurate results. This type of interference is difficult to detect analytically.
Objective:
A case of CARDIAC Troponin T Quantitative reader (Roche Diagnostics) assay failure was detected and investigated in order to ascertain the likely cause.
Method:
Patient whole blood was mixed with cardiac troponin T-positive blood, patient and control sera were denuded of immunoglobulin G by protein A-affinity chromatography and patient sera were mixed with mouse serum. Samples were analysed on a CARDIAC Troponin T Quantitative reader.
Results:
A mixture of patient whole blood and cardiac troponin T-positive blood resulted in assay failure; removal of immunoglobulin G from patient sera reversed the cardiac troponin T assay failure; the addition of mouse serum as a heterophile antibody blocking agent had no effect.
Conclusion:
It is proposed that the interference resulting in assay failure may not be because of a heterophile antibody, but rather a result of a circulating autoantibody to cardiac troponin T, which may compete with antibody assay reagents for binding sites.
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