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Undetectable luteinizing hormone levels using a monoclonal immunometric assay
F Barbé1, H Legagneur, V Watrin
1Service de Biologie Médicale, Maternité Régionale, Nancy, France.
Journal of Endocrinological Investigation
|November 1, 1995
Summary
Luteinizing hormone (LH) immunoassay results varied significantly between kits, leading to potential misdiagnosis in infertility and menopause cases. Further testing is recommended when results are unexpected or inconsistent.
Area of Science:
- Reproductive Endocrinology
- Clinical Chemistry
- Immunodiagnostics
Background:
- Discrepancies in luteinizing hormone (LH) assay results are a known issue in clinical diagnostics.
- Variations in immunoassay performance can impact patient diagnosis and treatment.
Purpose of the Study:
- To highlight significant discrepancies in LH detection across different immunometric assays.
- To investigate cases where LH was undetectable by one assay but detectable by others.
Main Methods:
- Analysis of five cases with undetectable LH by a specific immunometric assay (LH Stratus Baxter).
- Comparison of results with other commercially available LH assay kits.
- Evaluation of follicle-stimulating hormone (FSH) levels in conjunction with LH results.
Main Results:
- Five out of 4000 women showed undetectable LH with the Baxter kit, but detectable levels with other kits.
- Detectable LH results varied significantly, with some kits showing low levels and others > 7 IU/l.
- Observed discrepancies were more pronounced in postmenopausal women and when comparing pre- and post-menopausal samples.
Conclusions:
- Immunoassay variations, including standard calibration and antibody specificity, contribute to LH result discrepancies.
- The Baxter LH kit may misrecognize certain LH isoforms, particularly in postmenopausal women.
- Clinical laboratories should consider using secondary methodologies or bioassays for unexpected or discordant LH and FSH results to ensure accurate diagnosis.