IgM interference in the Abbott iVanco immunoassay: A case report

Florin, Lisa; Vantilborgh, Anna; Pauwels, Steven; Vanwynsberghe, T; Vermeersch, Pieter; Stove, Veronique

doi:10.1016/j.cca.2015.05.006

Cited by 7 publications

(8 citation statements)

References 5 publications

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“…The authors of this case attributed the spurious result to interference secondary to high IgM levels with the Abbott Architect immunoassay. 12 In contrast, the IgM level in this case was within normal limits. The literature search failed to identify any cases of immunoassay interference or falsely elevated vancomycin concentrations in patients with MS.…”

Section: Discussioncontrasting

confidence: 53%

“…An English‐language literature search (PubMed, Ovid; database inception to April 2019) identified a single case report of falsely elevated vancomycin concentrations. The authors of this case attributed the spurious result to interference secondary to high IgM levels with the Abbott Architect immunoassay . In contrast, the IgM level in this case was within normal limits.…”

Section: Discussionmentioning

confidence: 71%

“…Falsely low vancomycin concentrations, secondary to immunoglobulin (Ig)‐mediated interference, have been reported with PETINIA platforms including those manufactured by Beckman‐Coulter (DxC 800, Synchron) and Siemens (VISTA 1500) . In five publications involving seven cases of falsely low serum vancomycin concentrations, the reported results were considered suspect because all of the patients were receiving vancomycin before the time of serum sampling …”

Section: Discussionmentioning

confidence: 99%

“…5 In five publications involving seven cases of falsely low serum vancomycin concentrations, the reported results were considered suspect because all of the patients were receiving vancomycin before the time of serum sampling. [8][9][10][11][12] An English-language literature search (PubMed, Ovid; database inception to April 2019) identified a single case report of falsely elevated vancomycin concentrations. The authors of this case attributed the spurious result to interference secondary to high IgM levels with the Abbott Architect immunoassay.…”

Section: Discussionmentioning

confidence: 99%

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Falsely Elevated Vancomycin Concentrations in a Patient Not Receiving Vancomycin

et al. 2019

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Therapeutic drug monitoring (TDM) of vancomycin is commonly performed using immunoassays. This case describes falsely elevated vancomycin serum concentrations, possibly secondary to endogenous protein interference. Vancomycin was prescribed for a patient with a suspected septic knee. A blood sample for TDM was inadvertently collected before the first dose. The reported concentration was 36.1 mg/L using the Roche Modular P analyzer and remained high over the next 48 hours and 8 months later in the absence of vancomycin therapy. Vancomycin was undetectable in the patient sample by liquid chromatography‐tandem mass spectrometry. The sample was subsequently investigated for endogenous protein interference. The responsible interference was removed by polyethylene glycol precipitation and heat inactivation. Four alternative immunoassays with varying test principles measured vancomycin concentrations ranging from undetectable to 108 mg/L. A glucose‐6‐phosphate dehydrogenase detection method was common to the two immunoassays exhibiting the greatest interference. To our knowledge, this is the first report of falsely elevated vancomycin concentrations on the Roche Modular P analyzer. Immunoassays are generally robust in facilitating TDM but are susceptible to cross‐reactivity. Assay interference should be considered and laboratory professionals contacted when vancomycin levels do not correlate with clinical expectations.

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Section: Discussioncontrasting

confidence: 53%

Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Falsely Elevated Vancomycin Concentrations in a Patient Not Receiving Vancomycin

et al. 2019

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“…75 In another case, strongly elevated IgM concentrations were associated with falsely high vancomycin concentrations (>measuring range) using a CMIA (Architect analyzer; Abbott Laboratories). 76 Possible interfering factors should be considered in case of clinically incorrect-appearing results from immunoassays. Measures to detect the presence of immunoglobulin-mediated interference include analysis using another assay, reanalysis after sample dilution or ultrafiltration, or the use of heterophilic blocking reagents or tubes.…”

Section: Analysis Of Drug Concentrationsmentioning

confidence: 99%

Therapeutic Drug Monitoring of Antibiotic Drugs: The Role of the Clinical Laboratory

Shipkova

Jamoussi

2022

Therapeutic Drug Monitoring

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Background: Therapeutic drug monitoring (TDM) of antiinfective drugs is an increasingly complex field, given that in addition to the patient and drug as 2 usual determinants, its success is driven by the pathogen. Pharmacodynamics is related both to the patient (toxicity) and bacterium (efficacy or antibiotic susceptibility). The specifics of TDM of antimicrobial drugs stress the need for multidisciplinary knowledge and expertise, as in any other field. The role and the responsibility of the laboratory in this interplay are both central and multifaceted. This narrative review highlights the role of the clinical laboratory in the TDM process.Methods: A literature search was conducted in PubMed and Google Scholar, focusing on the past 5 years (studies published since 2016) to limit redundancy with previously published review articles. Furthermore, the references cited in identified publications of interest were screened for additional relevant studies and articles. Results:The authors addressed microbiological methods to determine antibiotic susceptibility, immunochemical and chromatographic methods to measure drug concentrations (primarily in blood samples), and endogenous clinical laboratory biomarkers to monitor treatment efficacy and toxicity. The advantages and disadvantages of these methods are critically discussed, along with existing gaps and future perspectives on strategies to provide clinicians with as reliable and useful results as possible.Conclusions: Although interest in the field has been the driver for certain progress in analytical technology and quality in recent years, laboratory professionals and commercial providers persistently encounter numerous unresolved challenges. The main tasks that need tackling include broadly and continuously available, easily operated, and cost-effective tests that offer short turnaround times, combined with reliable and easy-to-interpret results. Various fields of research are currently addressing these features.

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Therapeutic drug monitoring of antimicrobial, antifungal and antiviral agents

Dasgupta

Krasowski

2020

Therapeutic Drug Monitoring Data

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IgM interference in the Abbott iVanco immunoassay: A case report

Cited by 7 publications

References 5 publications

Falsely Elevated Vancomycin Concentrations in a Patient Not Receiving Vancomycin

Falsely Elevated Vancomycin Concentrations in a Patient Not Receiving Vancomycin

Therapeutic Drug Monitoring of Antibiotic Drugs: The Role of the Clinical Laboratory

Therapeutic drug monitoring of antimicrobial, antifungal and antiviral agents

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