人抗鼠抗体干扰促甲状腺激素检测导致促甲状腺激素水平假性升高。
Falsely raised TSH levels due to human anti-mouse antibody interfering with thyrotropin assay.
作者信息
Santhana Krishnan S G, Pathalapati R, Kaplan L, Cobbs R K
机构信息
Department of Nephrology, Long Island Jewish Medical Center, New Hyde Park, New York 11042, USA.
出版信息
Postgrad Med J. 2006 Nov;82(973):e27. doi: 10.1136/pmj.2006.049809.
Abstract
The case of a 39-year-old woman who was referred for weight gain and amenorrhoea is reported. Laboratory evaluation showed high levels of thyroid-stimulating hormone (TSH). The patient was started on increasing doses of levothyroxine for subclinical hypothyroidism. TSH remained persistently raised and the patient became thyrotoxic. Evaluation at another laboratory showed normal levels of TSH, raising the possibility of interfering substances. TSH levels were normalised with the addition of mouse serum to the patient's sample, confirming the presence of human anti-mouse antibodies as the interfering substance in the TSH assay.
摘要
报告了一名39岁因体重增加和闭经前来就诊的女性病例。实验室检查显示促甲状腺激素（TSH）水平升高。该患者因亚临床甲状腺功能减退开始服用递增剂量的左甲状腺素。TSH持续升高，患者出现甲状腺毒症。另一家实验室的检查显示TSH水平正常，提示可能存在干扰物质。在患者样本中加入小鼠血清后TSH水平恢复正常，证实人抗小鼠抗体是TSH检测中的干扰物质。
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本文引用的文献
1
2
Towards a better understanding of heterophile (and the like) antibody interference with modern immunoassays.旨在更好地理解嗜异性（及类似）抗体对现代免疫分析的干扰。
Clin Chim Acta. 2002 Nov;325(1-2):1-15. doi: 10.1016/s0009-8981(02)00275-9.
3
Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III).美国人群（1988年至1994年）的血清促甲状腺激素、甲状腺素及甲状腺抗体：国家健康与营养检查调查（第三次全国健康和营养检查调查，NHANES III）
J Clin Endocrinol Metab. 2002 Feb;87(2):489-99. doi: 10.1210/jcem.87.2.8182.
4
Subclinical hypothyroidism is mild thyroid failure and should be treated.亚临床甲状腺功能减退是轻度甲状腺功能衰退，应予以治疗。
J Clin Endocrinol Metab. 2001 Oct;86(10):4585-90. doi: 10.1210/jcem.86.10.7959.
5
Clinical practice. Subclinical hypothyroidism.临床实践。亚临床甲状腺功能减退症。
N Engl J Med. 2001 Jul 26;345(4):260-5. doi: 10.1056/NEJM200107263450406.
6
Human anti-mouse antibodies.人抗鼠抗体。
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7
Antibody interference in thyroid assays: a potential for clinical misinformation.甲状腺检测中的抗体干扰：临床信息误导的可能性。
Clin Chem. 1998 Mar;44(3):440-54.
8
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9
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