False lowering of thyroglobulin levels may also occur. Heterophile antibodies may also cause false depression of serum cortisol levels, resulting in incorrect diagnosis of hypothalamic-pituitary-adrenal axis insufficiency and inappropriate and potentially harmful replacement with glucocorticoids.
Heterophile antibodies may affect a wide array of laboratory tests, resulting in false elevation of tumour markers, endocrine tests, cardiac injury markers and drug levels ( Table 1). Heterophile antibodies can also bridge the two antibodies independently of antigen, resulting in an increase in labelled antibody concentration ( Figure 2).įigure 2. The antigen in the sample bridges the two antibodies so that the amount of labelled antibody that binds to the solid-phase is proportional to the antigen concentration in the sample ( Figure 1). These assays use at least two antibodies directed against different epitopes of an antigen: one bound to a solid-phase, the other in solution and tagged with a signal moiety. Two-site immunometric or sandwich assays are particularly susceptible to analytical error in the setting of heterophile antibodies. 2 Sources proposed for the induction of heterophile antibodies include exposure to mice and mouse products, immunisation, blood transfusion, autoimmune diseases, dialysis and maternal transfer. 1 In eight automated tumour marker immunoassays, the prevalence of heterophile antibodies was 0.2–3.7%. The prevalence of heterophile antibodies is 0.17–40% in the general population.
0 kommentar(er)
