Huang Dongni, Guo ZhiXuan, Fan JingWen, Zhao Yan, Pan Qi, Guo Lixin
Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China.
Chinese Academy of Medical Sciences, Graduate School of Peking Union Medical College, Beijing 100730, China.
JCEM Case Rep. 2025 Jul 2;3(8):luaf140. doi: 10.1210/jcemcr/luaf140. eCollection 2025 Aug.
Testosterone is commonly measured using immunoassays in clinical practice; however, these methods are subject to analytical interference in both men and women. In women, due to physiologically lower testosterone levels, even modest elevations may appear pathologic and complicate the diagnostic process. We report a case of a 43-year-old female patient with persistently elevated serum testosterone levels documented across multiple institutions. Despite comprehensive endocrine evaluations and imaging studies, no underlying cause could be identified. Ultimately, liquid chromatography-tandem mass spectrometry (LC-MS/MS) confirmed normal testosterone levels, indicating that the falsely elevated testosterone was due to assay interference. Further analysis using a protein precipitation assay revealed the presence of heterophilic antibodies, which were responsible for the assay interference. This case highlights the importance of considering immunoassay artifacts in the differential diagnosis of unexplained biochemical hyperandrogenism, particularly in the absence of clinical signs of androgen excess.
在临床实践中，睾酮通常采用免疫测定法进行检测；然而，这些方法在男性和女性中均会受到分析干扰。在女性中，由于生理上睾酮水平较低，即使是适度升高也可能看似病理性的，从而使诊断过程变得复杂。我们报告了一例43岁女性患者，多个机构记录其血清睾酮水平持续升高。尽管进行了全面的内分泌评估和影像学检查，但未发现潜在病因。最终，液相色谱 - 串联质谱法（LC-MS/MS）证实睾酮水平正常，表明睾酮假性升高是由于检测干扰所致。使用蛋白质沉淀法进一步分析发现存在嗜异性抗体，这是导致检测干扰的原因。该病例强调了在不明原因生化性高雄激素血症的鉴别诊断中考虑免疫测定假象的重要性，尤其是在没有雄激素过多临床体征的情况下。
