Falsely elevated serum estradiol due to heterophile antibody interference: a case report

Area of Science:

• Clinical Chemistry
• Endocrinology
• Laboratory Medicine

Background:

• Elevated estradiol levels can indicate various conditions, but false elevations are uncommon.
• Heterophile antibodies are known to interfere with immunoassays, potentially causing inaccurate results.
• Accurate estradiol measurement is crucial for appropriate patient management and avoiding unnecessary interventions.

Observation:

• A 56-year-old female presented with estradiol levels inconsistent with her clinical presentation.
• Initial laboratory results suggested significantly elevated estradiol, prompting further clinical concern.
• The discrepancy between lab values and clinical picture necessitated an investigation into potential interferences.

Findings:

• The falsely elevated estradiol levels were identified as being caused by heterophile antibody interference.
• Employing alternative analytical platforms and a heterophile antibody blocking agent confirmed the interference.
• This interference led to an unnecessary surgical procedure for the patient.

Implications:

• Clinicians should consider laboratory error, specifically heterophile antibody interference, when results contradict clinical findings.
• Implementing robust diagnostic strategies to identify and mitigate immunoassay interferences is essential.
• Suspecting and investigating lab errors can prevent misdiagnosis, unnecessary treatments, and patient harm.