Medial Diagnostic Centers, Hoofddorp, The Netherlands.
Ann Clin Biochem. 2011 May;48(Pt 3):276-81. doi: 10.1258/acb.2010.010160. Epub 2011 Mar 25.
There are many causes of interference in immunoassays causing erratic patient results. A method-specific interference due to antiruthenium antibodies in Roche free thyroxine (fT4) and free triiodothyronine (fT3) assays has been described previously. As a result, a new generation fT4 assay has been introduced by Roche. We describe six cases of interference due to antiruthenium antibodies, where in four cases interference in the Roche thyroid-stimulating hormone (TSH) assay was found as well. This raised the question as to whether other assays on this platform would also give incorrect results in patients with antiruthenium antibodies. Interference due to antiruthenium antibodies was suspected because of discrepancies between clinical presentation and/or TSH, fT4 and fT3 results. Samples of these six patients were re-analysed in Roche Diagnostics Laboratory, where it was demonstrated that the found discrepancies were indeed caused by interfering antiruthenium antibodies. Subsequently, these patients were asked to donate some blood once more for further evaluation, and three subjects agreed to participate. Their plasma was used to assay 18 analytes on Modular E and on a ruthenium-independent platform. The results were compared taking into account the known differences between distinct methods. As expected, significant interference was found in TSH. Also, in the new generation fT4 assay, ruthenium-induced interference was still present. However, the other assays, both competitive and immunometric, did not show clear interference. We therefore conclude that although antiruthenium antibodies theoretically can interfere in all assays on the Modular E platform, this kind of interference is found in the thyroid hormone assays, without marked interference in the other assays.
免疫分析中存在许多干扰因素，导致患者结果不稳定。先前已经描述了罗氏游离甲状腺素（fT4）和游离三碘甲状腺原氨酸（fT3）测定中由于抗钌抗体引起的方法特异性干扰。因此，罗氏推出了新一代 fT4 测定法。我们描述了六例由于抗钌抗体引起的干扰病例，其中四例罗氏促甲状腺激素（TSH）测定也发现了干扰。这引发了一个问题，即在具有抗钌抗体的患者中，其他平台上的其他测定是否也会给出不正确的结果。由于临床表型和/或 TSH、fT4 和 fT3 结果之间存在差异，怀疑存在抗钌抗体引起的干扰。罗氏诊断实验室对这六名患者的样本进行了重新分析，结果表明发现的差异确实是由干扰性抗钌抗体引起的。随后，这些患者被要求再次捐献一些血液以进行进一步评估，有三位同意参与。他们的血浆用于在 Modular E 和非依赖钌的平台上检测 18 种分析物。考虑到不同方法之间已知的差异，对结果进行了比较。正如预期的那样，在 TSH 中发现了明显的干扰。此外，在新一代 fT4 测定中，仍存在钌诱导的干扰。然而，其他测定，包括竞争和免疫测定，均未显示出明显的干扰。因此，我们得出结论，尽管抗钌抗体理论上可以干扰 Modular E 平台上的所有测定，但这种干扰仅在甲状腺激素测定中发现，而在其他测定中未发现明显干扰。
