免疫测定干扰引起的假性甲状腺功能亢进
False hyperthyroidism caused by interference in immunoassays.
作者信息
Jiménez García Clara, Ortega Fernández Piedad, Torregrosa Quesada María Eugenia, González Bueno Victoria, Botella Belda María Teresa, Guerra Rocío Alfayate
机构信息
Laboratory of Hormones, Hospital General Universitario de Alicante, Pintor Baeza 11, Alicante, Spain.
Laboratory of Clinical Chemistry, Hospital General Universitario de Elche, Almazara, Elche, Spain.
出版信息
Adv Lab Med. 2020 Nov 13;2(1):121-128. doi: 10.1515/almed-2020-0097. eCollection 2021 Mar.
OBJECTIVES
Immunoassays used to assess thyroid function are vulnerable to different types of interference that may affect clinical decision-making.
CASE PRESENTATION
We report the case of a 37-year-old woman who developed iatrogenic hypothyroidism after having received radioiode therapy who visited our hospital for her annual checkup. The patient was asymptomatic, without signs suggestive of thyroid disease. However, laboratory analysis proved otherwise: thyrotropin (TSH) 7.75 mU/L, thyroxine (FT4) >7.7 ng/dL.
CONCLUSIONS
The inconsistency between her clinical symptoms and the biochemistry data raised the possibility of a methodological interference. A thorough evaluation of the main causes of interference was conducted in the laboratory to exclude the presence of interference in TSH and FT4. Finally, different interfering agents were identified, which affected free thyroid hormone and TSH determination.
目的
用于评估甲状腺功能的免疫测定易受不同类型干扰的影响，这可能会影响临床决策。
病例介绍
我们报告一例37岁女性病例，该患者在接受放射性碘治疗后发生医源性甲状腺功能减退，前来我院进行年度体检。患者无症状，无提示甲状腺疾病的体征。然而，实验室分析结果却并非如此：促甲状腺激素（TSH）为7.75 mU/L，游离甲状腺素（FT4）>7.7 ng/dL。
结论
她的临床症状与生化数据之间的不一致增加了方法学干扰的可能性。实验室对干扰的主要原因进行了全面评估，以排除TSH和FT4检测中存在干扰。最终，确定了不同的干扰因素，这些因素影响了游离甲状腺激素和TSH的测定。
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