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Titolo:
False serum calcitonin high levels using a non-competitive two-site IRMA
Autore:
Tommasi, M; Brocchi, A; Cappellini, A; Raspanti, S; Mannelli, M;
Indirizzi:
Univ Florence, Dipartimento Fisiopatol Clin, Sez Med Nucl, Nucl Med Unit, I-50134 Florence, Italy Univ Florence Florence Italy I-50134 l Med Unit, I-50134 Florence, Italy Univ Florence, Dept Clin Physiopathol, Endocrinol Unit, I-50134 Florence, Italy Univ Florence Florence Italy I-50134 rinol Unit, I-50134 Florence, Italy
Titolo Testata:
JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION
fascicolo: 5, volume: 24, anno: 2001,
pagine: 356 - 360
SICI:
0391-4097(200105)24:5<356:FSCHLU>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
MEDULLARY-THYROID CARCINOMA; PENTAGASTRIN STIMULATION TEST; CREATINE-KINASE-MB; HETEROPHILIC ANTIBODIES; ROUTINE MEASUREMENT; 2-SITE IMMUNOASSAY; MEN 2A; INTERFERENCE; DIAGNOSIS; FAMILIES;
Keywords:
calcitonin; immunoassay; analytical interference; heterophilic antibodies; medullary thyroid cancer;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
16
Recensione:
Indirizzi per estratti:
Indirizzo: Tommasi, M Univ Florence, Dipartimento Fisiopatol Clin, Sez Med Nucl, NuclMed Unit, Vle Morgagni 85, I-50134 Florence, Italy Univ Florence Vle Morgagni 85 Florence Italy I-50134 ce, Italy
Citazione:
M. Tommasi et al., "False serum calcitonin high levels using a non-competitive two-site IRMA", J ENDOC INV, 24(5), 2001, pp. 356-360

Abstract

Dual site antibody-base immunoassays are commonly used in clinical laboratories to quantify the CT serum concentrations as a specific and sensitive marker of medullary thyroid carcinoma (MTC). Heterophile antibodies can interfere with these assays, however, and cause erroneous results. In order to avoid this interference, immobilized and conjugated antibodies from two different animal species or immunoreactive antibody fragments, as well as the addition of non-immune globulins, are generally included among the assay reagents. We describe the case of a 73-year-old man affected by a multinodular goiter, who showed high basal CT plasma levels as measured by a monoclonal antibody based IRMA. The finding of negative results for the presence of MTC at fine needle aspiration (FNA) and the mild increase observed in plasma CT during a pentagastrin (Pg) stimulation test, suggested that the high CT levels might depend on a cross-reaction with heterophilic antibodies. In fact, after the addition of the heterophilic blocking tube (HBT) to each specimen, the CT levels markedly decreased by more than 80% (average decrease+/- SE= 87.6 +/-2.668%). Such a decrease strongly suggests that in our case the routinely used F(ab ')(2) fragments were unable to eliminate all of the interference and that the elevated serum CT levels might have been caused by human heterophilic antibodies. In conclusion, these results indicate anovel cause of CT false positivity, suggesting that high serum CT levels, when combined with a slight increase during Pg stimulation, should be critically interpreted in view of the possible presence of heterophilic antibodies in the specimens.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/11/20 alle ore 00:46:11