Department of Clinical Biochemistry and Hematology, University Hospital and Faculty of Medicine, Charles University, Pilsen, Czech Republic.
Department of Gynecology and Obstetrics, Klatovska Hospital, Klatovy, Czech Republic.
Biochem Med (Zagreb). 2023 Feb 15;33(1):010802. doi: 10.11613/BM.2023.010802.
Immunochemical reactions are fast, can be automated, and generally do not require pretreatment of biological material. Based on these advantages, they are widely used. On the other hand, they are susceptible to analytical interference that can lead to inaccurate results. These factors include the presence of anti-mouse antibodies, causing false positive (or sometimes false negative) results. Although the anti-mouse antibodies over many decades have been repeatedly identified to be the causative source but due to the rarity of such encounters they remain insufficiently considered. Here we show a case, a 45 year-old female who was mis-diagnosed with pregnancy due to falsely elevated human chorionic gonadotropin (hCG) due to anti-mouse antibodies. This led to the patient undergoing two ultrasound examinations and laparoscopy before the hCG was repeated on alternative assays which showed negative results, preventing the patient from methotrexate treatment. Here we describe the details of the case, outline the assay principal, supporting the finding from literature and outlining a process on how to identify such interferences in timely manner.
免疫化学反应速度快,可以自动化,通常不需要对生物材料进行预处理。基于这些优点,它们被广泛应用。另一方面,它们容易受到分析干扰,从而导致不准确的结果。这些因素包括抗鼠抗体的存在,导致假阳性(或有时假阴性)结果。尽管抗鼠抗体在过去几十年中已被反复确定为致病源,但由于此类情况罕见,因此仍未得到充分考虑。在这里,我们展示了一个案例,一名 45 岁女性因抗鼠抗体导致人绒毛膜促性腺激素(hCG)假性升高而被误诊为怀孕。这导致患者接受了两次超声检查和腹腔镜检查,然后在替代检测中 hCG 结果为阴性,从而避免了对患者进行甲氨蝶呤治疗。在这里,我们详细描述了该病例,概述了检测原理,支持了文献中的发现,并概述了如何及时识别此类干扰的过程。