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Updated: Aug 19, 2025

Generation of a Mouse Spontaneous Autoimmune Thyroiditis Model
Published on: March 17, 2023
Thyroglobulin Assay Interferences: Clinical Usefulness of Mass-Spectrometry Methods
Giuseppe Barbesino1, Alicia Algeciras-Schimnich2, Joshua Bornhorst2
1Thyroid Unit, Massachusetts General Hospital-Harvard Medical School, Boston, MA 02114, USA.
Thyroglobulin mass spectrometry (TgMS) can identify heterophilic antibody interference, which causes falsely elevated thyroglobulin immunometric assays (TgIMA). However, TgMS may not detect structural disease in patients with thyroglobulin autoantibodies (TgAb).
Area of Science:
- Clinical Chemistry
- Immunochemistry
- Mass Spectrometry
Background:
- Thyroglobulin autoantibodies (TgAbs) can cause falsely low thyroglobulin immunometric assay (TgIMA) results.
- Heterophilic antibodies (HAs) can cause falsely elevated TgIMA results.
- Thyroglobulin (Tg) measurements using mass spectrometry (MS) are resistant to antibody interference.
Purpose of the Study:
- To evaluate the utility of TgMS compared to TgIMA in the presence of TgAb and HA interference.
- To determine the impact of TgAb and HA on Tg measurements using different assay methods.
Main Methods:
- Compared TgIMA and TgMS in 163 thyroid cancer patients.
- Assessed HA interference using serial dilution and HA blocking reagent.
- Analyzed TgIMA and TgMS correlation in TgAb-positive patients.
Main Results:
- Heterophilic antibody interference was confirmed in 6/45 cases with elevated TgIMA and undetectable TgMS.
- TgIMA and TgMS showed high correlation (R² = 0.86) in TgAb-positive patients.
- In TgAb-positive patients with structural disease, TgMS detected Tg in 9/19 cases, while TgIMA detected it in 6/19.
Conclusions:
- Mass spectrometry (MS) is effective for identifying heterophilic antibody interference.
- Thyroglobulin autoantibodies (TgAbs) may lead to falsely reduced Tg concentrations in vivo, potentially impacting disease detection by TgMS.
- TgMS may not reliably detect structural disease in TgAb-positive patients.
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