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首页> 外文期刊>Practical Laboratory Medicine >Serum sample containing endogenous antibodies interfering with multiple hormone immunoassays. Laboratory strategies to detect interference
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Serum sample containing endogenous antibodies interfering with multiple hormone immunoassays. Laboratory strategies to detect interference

机译：血清样品中含有干扰多种激素免疫测定的内源性抗体。检测干扰的实验室策略

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Objectives Endogenous antibodies (EA) may interfere with immunoassays, causing erroneous results for hormone analyses. As (in most cases) this interference arises from the assay format and most immunoassays, even from different manufacturers, are constructed in a similar way, it is possible for a single type of EA to interfere with different immunoassays. Here we describe the case of a patient whose serum sample contains EA that interfere several hormones tests. We also discuss the strategies deployed to detect interference. Subjects and methods Over a period of four years, a 30-year-old man was subjected to a plethora of laboratory and imaging diagnostic procedures as a consequence of elevated hormone results, mainly of pituitary origin, which did not correlate with the overall clinical picture. Results Once analytical interference was suspected, the best laboratory approaches to investigate it were sample reanalysis on an alternative platform and sample incubation with antibody blocking tubes. Construction of an in-house ‘nonsense’ sandwich assay was also a valuable strategy to confirm interference. In contrast, serial sample dilutions were of no value in our case, while polyethylene glycol (PEG) precipitation gave inconclusive results, probably due to the use of inappropriate PEG concentrations for several of the tests assayed. Conclusions Clinicians and laboratorians must be aware of the drawbacks of immunometric assays, and alert to the possibility of EA interference when results do not fit the clinical pattern.
机译：目的内源性抗体（EA）可能会干扰免疫测定，导致激素分析结果错误。由于（在大多数情况下）这种干扰来自测定形式，而且大多数免疫测定（甚至来自不同制造商）的构建方式也相似，因此一种类型的EA可能会干扰不同的免疫测定。在这里，我们描述了一个患者的血清样本中含有EA的情况，该EA会干扰几种激素测试。我们还将讨论部署用于检测干扰的策略。受试者和方法在四年的时间里，一名30岁的男子因激素结果升高（主要是垂体起源）而接受了过多的实验室和影像学诊断程序，这与总体临床情况无关。结果一旦怀疑存在分析干扰，最好的实验室研究方法是在其他平台上进行样品重新分析，并用抗体封闭管进行样品孵育。内部“废话”夹心测定的构建也是确认干扰的宝贵策略。相比之下，在我们的案例中，连续样品稀释没有任何价值，而聚乙二醇（PEG）沉淀的结果尚无定论，这可能是由于在某些测试中使用了不合适的PEG浓度。结论临床医师和实验室医师必须意识到免疫测定法的弊端，并在结果不符合临床模式时警惕EA干扰的可能性。

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