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Falsely elevated D-dimer partially caused by heterophilic antibodies: A case report
Hui Ma1, Chun-Hua Chen1, Yan-Mei Li1
1Department of Gastroenterology, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China.
Summary
Falsely elevated D-dimer levels, a marker for blood clots, can be caused by heterophilic antibodies. Identifying this interference is crucial to prevent misdiagnosis and unnecessary medical procedures.
Area of Science:
- Clinical Chemistry
- Immunology
- Laboratory Medicine
Background:
- Plasma D-dimer is a vital screening marker for thrombosis and hemostasis disorders.
- Accurate D-dimer measurement is essential to avoid misdiagnosis and invasive procedures.
- Immunoassays used for D-dimer determination are susceptible to interference from heterophilic antibodies.
Observation:
- A case presented with falsely elevated D-dimer levels.
- Heterophilic antibody interference was investigated using dilution tests, polyethylene glycol precipitation, and a heterophilic blocking reagent.
- Most methods indicated heterophilic antibody interference, but polyethylene glycol precipitation did not normalize D-dimer levels.
Findings:
- The elevated D-dimer levels were partially attributed to heterophilic antibody interference.
- The heterophilic blocking reagent effectively identified the interference, while polyethylene glycol precipitation was less conclusive.
Implications:
- Recognizing heterophilic antibody interference is critical for accurate D-dimer interpretation in laboratory practice.
- This understanding can prevent unnecessary patient anxiety and costly, invasive diagnostic workups.
- Further research into robust methods for detecting and mitigating antibody interference in immunoassays is warranted.
