Verhoye Eline, Van den Bruel Annick, Delanghe Joris R, Debruyne Evi, Langlois Michel R
Department of Clinical Chemistry, AZ St-Jan, Bruges, Belgium.
Clin Chem Lab Med. 2009;47(5):604-6. doi: 10.1515/CCLM.2009.138.
Three adult patients presented with unexpectedly high thyrotropin (TSH) concentrations that were discordant with clinical and biochemical findings of euthyroid or hyperthyroid status.
Antibody interference in the TSH immunoassay (Roche) was investigated by polyethylene glycol (PEG)-pretreatment, heterophilic blocking tube (HBT)-pretreatment, rheumatoid factor (RF) testing, immunofixation, protein A adsorption, and gel filtration chromatography (GFC).
PEG-precipitation yielded<20% recovery of serum TSH, whereas HBT-pretreatment did not decrease TSH test results. RF-testing and immunofixation were negative. Protein A adsorption and GFC demonstrated the presence of TSH-immunoglobulin complexes in serum.
Interference by TSH-immunoglobulin complexes should be ruled out in euthyroid and hyperthyroid patients presenting with inappropriately increased or non-suppressed TSH values.
三名成年患者的促甲状腺激素（TSH）浓度意外升高，这与甲状腺功能正常或甲状腺功能亢进状态的临床及生化检查结果不一致。
通过聚乙二醇（PEG）预处理、嗜异性抗体封闭管（HBT）预处理、类风湿因子（RF）检测、免疫固定、蛋白A吸附及凝胶过滤色谱法（GFC），研究TSH免疫测定法（罗氏）中的抗体干扰情况。
PEG沉淀法使血清TSH回收率<20%，而HBT预处理并未降低TSH检测结果。RF检测及免疫固定均为阴性。蛋白A吸附及GFC表明血清中存在TSH-免疫球蛋白复合物。
对于甲状腺功能正常及甲状腺功能亢进但TSH值异常升高或未被抑制的患者，应排除TSH-免疫球蛋白复合物的干扰。
