Haddad Raad A, Giacherio Donald, Barkan Ariel L
1Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan Medical Center, 24 Frank Lloyd Wright, G-1500, Ann Arbor, MI 48106 USA.
2Department of Pathology, University of Michigan Medical Center, Ann Arbor, MI USA.
Clin Diabetes Endocrinol. 2019 Jul 24;5:12. doi: 10.1186/s40842-019-0086-7. eCollection 2019.
Pitfalls in hormonal assays are commonly seen in clinical practice and may lead to erroneous clinical impressions and treatments. In this article, we address common laboratory pitfalls encountered during evaluation of patients with real or presumed endocrine disorders including high dose hook effect and falsely normal prolactin in cases of macroprolactinomas, macroprolactinemia and falsely elevated prolactin, macrothyrotropinemia and falsely elevated TSH, heterophile antibodies leading to false elevation of hormonal concentration, biotin interference with different hormonal assays, cross-reactivity of steroid hormones immunoassays, and others. We describe the mechanisms of such laboratory pitfalls, review clinical scenarios in which they might occur, and discuss the ways to resolve such conundrums. The aim of this article is to present a learning material for the endocrine trainees and practitioners.
激素检测中的陷阱在临床实践中很常见，可能会导致错误的临床判断和治疗。在本文中，我们探讨了在评估患有实际或疑似内分泌疾病的患者时遇到的常见实验室陷阱，包括大剂量钩状效应、大泌乳素瘤、巨泌乳素血症和泌乳素假性正常、泌乳素假性升高、大促甲状腺素血症和促甲状腺激素假性升高、异嗜性抗体导致激素浓度假性升高、生物素对不同激素检测的干扰、类固醇激素免疫检测的交叉反应等。我们描述了这些实验室陷阱的机制，回顾了它们可能发生的临床情况，并讨论了解决这些难题的方法。本文的目的是为内分泌科实习生和从业者提供一份学习资料。
