False High Results in Multiple Hormone Immunoassays: A Case Report

多項賀爾蒙檢測出現假性升高：案例報告

徐惠娟(Hui-Chuan Hsu) ； 方雅潔(Ya-Chieh Fang) ； 林慶齡(Ching-Ling Lin) ； 李怡璇(Yi-Hsuan Li) ； 張維倫(Wei-Lun Chang)

《輔仁醫學期刊》 17卷1期 (2019/03) Pp. 41-47

https://doi.org/10.3966/181020932019031701006

摘要

Most hormone levels are measured using immunoassays that utilize animal-based reagent antibodies to identify the analytes of interest. With advances in immunoassay technology, modern instruments are required to minimize potential interference and ensure accuracy. Exaggerated analytical errors are currently uncommon. Herein, we report a 61-year-old woman with an elevated thyroid-stimulating hormone level (＞ 100 uIU/mL) in her health checkup report. Unexpectedly, other hormones were also high, including prolactin, luteinizing hormone, follicle-stimulating hormone and estradiol. Considerably different results were obtained in alternative analysis platforms. Further investigation revealed that the patient had a high level of rheumatoid factor. Patient sample was pretreated with heterophilic blocking tube, the rheumatoid factor level was significantly reduced, and hormone levels were close to normal on the original analytical platform. We believe the false high results of multiple hormones caused by rheumatoid factor-related interference.

關鍵字

rheumatoid factor ； immunoassay interference ； heterophilic antibody

並列摘要

大多數賀爾蒙檢測都採用免疫分析法，其原理是以動物抗體為基底的試劑抗體去識別目標分析物。隨著科技進步，現代儀器皆具防干擾的設計，誇張的分析錯誤實不常見。我們報告一名61歲女士體檢甲促素值大於100 uIU/mL，繼而發現泌乳素、黃體促素、濾泡促素和雌二醇值亦很高，但無症狀，改以其他平台檢驗，結果卻截然不同。進一步檢驗得知患者的類風濕因子（RF）濃度很高，經異嗜性抗體阻滯試管處理，RF明顯下降，賀爾蒙值也降至接近正常。

並列關鍵字

類風濕因子 ； 免疫分析干擾 ； 異嗜性抗體