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Interferences in hormone immunoassays
1Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, 200 First Street Southwest, Rochester, MN 55905, USA. klee.george@mayo.edu
Insights
Immunoassays are robust, but interference can occur. Laboratories rely on clinician communication and specific tests to investigate potential immunoassay interference and ensure accurate results.
Area of Science:
- Clinical Chemistry
- Laboratory Medicine
- Analytical Chemistry
Background:
- Immunoassays are widely used for diagnostic testing.
- Potential interferences can compromise immunoassay accuracy.
- Identifying interference before testing is not feasible.
Purpose of the Study:
- To discuss common causes of immunoassay interference.
- To outline strategies for investigating suspected interference.
- To highlight the importance of laboratory-clinician communication.
Main Methods:
- Review of common immunoassay interference types (cross-reactivity, heterophile antibodies).
- Description of investigative techniques: dilutional linearity, spiked recovery, heterophile antibody blocking, alternate technology testing.
- Emphasis on post-analytical investigation triggered by clinical suspicion.
Main Results:
- Competitive immunoassays are prone to cross-reactivity.
- Immunometric assays frequently encounter heterophile antibody interference.
- Investigative methods can help identify and confirm assay interference.
Conclusions:
- Immunoassays are generally reliable measurement systems.
- Laboratories must depend on clinicians to flag potentially erroneous results due to interference.
- Systematic investigation protocols are essential for managing immunoassay interference.
Abstract:
Despite the numerous potential interferences that were discussed in this article, immunoassays, in general, are robust measurement systems. There is no practical way to identify specimens a priori that are likely to have immunoassay interference. Therefore, laboratories must rely on communication from clinicians to identify suspicious test values that may be caused by assay interference. After laboratories are alerted, multiple investigations can be undertaken. The common causes of immunoassay interferences (see Box I) are dependent on the analytic format. Competitive assays are most likely to have problems with cross-reactivity, whereas immunometric assays most often have problems with heterophile antibodies. The simple steps to test for dilutional linearity, spiked recovery, heterophile antibody blocking,and testing with alternate technology can help in the evaluations of cases that are suspected to have assay interference.
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