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Published on: March 23, 2018
Antibody interference in thyroid assays: a potential for clinical misinformation
1Department of Clinical Biochemistry, Centre universitaire de santé de l'Estrie, Sherbrooke, Québec, Canada.
Clinical Chemistry
|March 25, 1998
Summary
Thyroid hormone testing can be disrupted by interfering antibodies in serum samples. Recognizing these interferences is crucial for accurate thyroid function evaluation and diagnosis.
Area of Science:
- Clinical Chemistry
- Endocrinology
- Immunology
Background:
- Thyroid function tests, including measurements of thyrotropin (TSH), thyroxine (T4), and triiodothyronine (T3), are essential for diagnosing thyroid disorders.
- Nonspecific binding in serum samples can interfere with these assays, leading to inaccurate hormone level reporting.
- Interfering antibodies, such as thyroid hormone autoantibodies, heterophile antibodies (including human anti-mouse antibodies), and rheumatoid factors, are implicated in these assay disturbances.
Purpose of the Study:
- To review the nature, occurrence, prevalence, and detection of antibody-mediated interferences in thyroid hormone immunoassays.
- To discuss the clinical consequences of unrecognized assay interferences on patient diagnosis and management.
Main Methods:
- Review of recent case reports and literature on antibody interferences in thyroid hormone assays.
- Discussion of the mechanisms by which different types of antibodies interfere with thyrotropin and thyroid hormone measurements.
- Examination of methods for detecting and mitigating assay interference.
Main Results:
- Thyroid hormone autoantibodies can bind to hormone tracers, affecting measurements.
- Heterophile antibodies and rheumatoid factors can cause interferences in two-site immunoassays for thyrotropin through immunoglobulin aggregation or cross-linking.
- These interferences can result in reported hormone concentrations inconsistent with a patient's actual thyroid status.
Conclusions:
- Antibody-mediated interferences pose a significant challenge in accurate thyroid hormone testing.
- Awareness and appropriate detection methods are critical to avoid misdiagnosis and ensure correct clinical management of thyroid conditions.
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