Positive and negative interference in immunoassays following biotin ingestion: a pharmacokinetic study

Wijeratne, Nilika; Doery, James C.G.; Lu, Zhong X.

doi:10.1097/pat.0b013e32835a3c17

Cited by 78 publications

(53 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Questa segnalazione ha portato al commento di Wijeratne et al [33], che hanno segnalato il caso di un bambino trattato alla posologia di 30 mg/die per insufficienza epatica da acidosi lattica, in cui fT4 e fT3, misurati con Dxi (Beckman Coulter), erano risultati marcatamente elevati e TSH nei limiti. I campioni rianalizzati, utilizzando Architect (Abbott, Roma, Italia) e Centaur (Siemens) erano risultati nei limiti.…”

Section: Il Passatounclassified

Biotina e interferenze nei metodi immunologici; problemi e opportunità

Dorizzi

2017

Riv Ital Med Lab

View full text Add to dashboard Cite

Riassunto La biotina è una vitamina idrosolubile del gruppo B nota anche con altri nomi: coenzima R, vitamina H (o più raramente vitamina I) nella nomenclatura tedesca, vitamina B 7 in quella anglosassone e vitamina B 8 in quella francese. La molecola della biotina comprende due anelli: uno tiofenico, a cui è legata una catena laterale di acido valerico, e uno imidazolidinonico. La biotina è un cofattore che interviene nel trasferimento di una molecola di CO 2 in numerose carbossilasi coinvolte nella sintesi degli acidi grassi, dell'isoleucina, della valina e nella gluconeogenesi. Non è definito in modo unanime il fabbisogno di biotina, anche se diverse fonti lo collocano intorno a 30-100 µg/die. Un deficit sublinico causa sintomi lievi come fragilità e perdita di capelli e sono stati attribuiti a carenza di biotina nell'adulto sintomi neurologici (depressione, letargo, allucinazioni). Deficit ereditari delle carbossilasi biotina-dipendenti impediscono alle cellule di utilizzare in modo efficiente la biotina con conseguenze che possono essere molto gravi e arrivare alla morte. Alla fine del secolo scorso ha cominciato a diffondersi nei Laboratori e nell'industria dei diagnostici l'impiego di sistemi che sfruttano la capacità della biotina di legarsi con grande affinità alla streptavidina, che si trova in Streptomyces avidinii. Mentre le supplementazioni tradizionali di biotina non hanno mai comportato interferenze sui metodi immunometrici che si basano sul sistema streptavidina-biotina, negli ultimi anni è stato segnalato che l'assunzione di biotina a concentrazioni superiori centinaia e migliaia di volte a quelle fisiologiche può produrre interferenze rilevanti. La streptavidina lega, secondo l'architettura del metodo, l'anticorpo o l'antigene biotinilato. Quando la B R.M. Dorizzi romolo.dorizzi@auslromagna.it 1 UOC Patologia Clinica, Laboratorio Unico della Romagna, Pievesestina di Cesena (FC), Italia concentrazione di biotina nel siero del paziente è molto aumentata, le molecole di biotina interferiscono con il legame degli anticorpi o degli antigeni biotinilati alla fase solida rivestita di streptavidina. I risultati di laboratorio sono falsamente diminuiti nel caso di metodiche sandwich o falsamente aumentati nel caso di metodiche competitive. L'editoriale commenta brevemente quanto pubblicato fino al gennaio 2017 e contiene una proposta operativa oggettiva, equilibrata e basata sulle "prove" a disposizione. Il Laboratorio non deve perdere l'occasione di svolgere un ruolo di consulente per il medico prescrittore, il paziente e il cittadino nell'interpretazione di un risultato di un esame. La possibilità di interferenze della biotina sugli immunodosaggi deve essere conosciuta, ma in Italia sembra comunque un fenomeno molto limitato. Occorre, pertanto, intercettare le richieste al momento dell'accettazione con la collaborazione dei medici prescrittori e dei sistemi informativi aziendali e regionali. Parole chiave Biotina

show abstract

Section: Il Passatounclassified

Biotina e interferenze nei metodi immunologici; problemi e opportunità

Dorizzi

2017

Riv Ital Med Lab

View full text Add to dashboard Cite

show abstract

“…The time response curve revealed that the extent of change in immunoassay results was maximum 2 h post a 30 mg biotin ingestion, and was significant up to 25 h [13]. As expected, the time interval is longer for biotin 300 mg dose in neurology, with a calculated half-life varying between 7.8 and 18.8 h, and maximum biotin concentration averaging 823 ± 303 µg/L (3374 ± 1242 nmol/L) [15].…”

Section: Time Response Curve Following Ingestion Of Biotinmentioning

confidence: 99%

“…As a matter of fact, if these data are obtained by in vitro spiking experiments, they might not reflect what happens in vivo (see below). Whatever the method used to study the interference, it seems that the magnitude of change in concentration is very different among the different analytes [13].…”

Section: Magnitude Of Change In Concentration: a Dose-dependent Intermentioning

confidence: 99%

“…This usual dietary intake is not expected to be high enough to affect immunoassays based on the streptavidin-biotin binding [11]. However, patients with inherited metabolic diseases like propionic acidemia, biotinidase deficiency, (and patients with parenteral nutrition) receive higher dosage of biotin, with daily oral doses in case of inherited metabolic diseases ranging from 10 to 40 mg per day [12,13]. Supraphysiological biotin administration is also used in some auto-medication aimed at reducing hair loss or fortifying hair and nails (up to 20 mg per day).…”

Section: Biotin Intakementioning

confidence: 99%

See 1 more Smart Citation

False biochemical diagnosis of hyperthyroidism in streptavidin-biotin-based immunoassays: the problem of biotin intake and related interferences

Piketty¹,

Polak

Flechtner

et al. 2017

Clinical Chemistry and Laboratory Medicine (CCLM)

View full text Add to dashboard Cite

Abstract:Immunoassays are now commonly used for hormone measurement, in high throughput analytical platforms. Immunoassays are generally robust to interference. However, endogenous analytical error may occur in some patients; this may be encountered in biotin supplementation or in the presence of anti-streptavidin antibody, in immunoassays involving streptavidin-biotin interaction. In these cases, the interference may induce both false positive and false negative results, and simulate a seemingly coherent hormonal profile. It is to be feared that this type of errors will be more frequently observed. This review underlines the importance of keeping close interactions between biologists and clinicians to be able to correlate the hormonal assay results with the clinical picture.

show abstract

“…This could lead to a misdiagnosis of Graves' disease. Biotin also interferes with the measurement of testosterone, oestradiol, dehydroepiandrosterone-sulfate (DHEAS), parathyroid hormone, ferritin and thyroglobulin, testosterone, thyroglobulin, leutinizing hormone (LH), follicle stimulating hormone (FSH), sex hormone binding globulin (SHBG), vitamin B12 and folate (4 …”

mentioning

confidence: 99%

Biotin treatment causing erroneous immunoassay results: A word of caution for clinicians

Sulaiman

2016

DD&T

View full text Add to dashboard Cite

Knowledge of biotin induced immunoassay interference is crucial for clinicians as not only biotin is used to treat certain inherited metabolic disorders and multiple sclerosis, it is also widely consumed as nutritional supplement. We recently had experience of erroneous thyroid function test (TFT) results in three adult patients receiving high doses of biotin (1-10 mg/kg body weight daily) to treat their inherited metabolic disorders. Two patients with biotin responsive basal ganglia disease had depression which triggered the request for TFT (1). Another patient with biotinidase deficiency brought in abnormal TFT results performed in another hospital. Although these patients were clinically euthyroid, their TFT persistently showed high free thyroxine ( showed normal FT4, FT3 and TSH results, confirming biotin induced immunoassay interference in Roche method. Since biotin is a water soluble vitamin and is rapidly cleared from the body, we repeated TFT of one patient 13 hours after the last dose of biotin, on Roche platform. There were significant changes in TFT as FT4 and TSH were normalized to18.5 nmol/L and 0.51 mU/ L respectively.Biotin or vitamin B7 acts as a coenzyme for different carboxylases involved in gluconeogenesis, fatty acid synthesis and in certain amino acid catabolism. High concentration of biotin in blood interferes with the immunoassays which rely on the biotin streptavidin interaction as an immobilizing system (2). Henry et al. first described biotin interference in immunoassay yielding erroneous TSH and FT4 results of a newborn who was on biotin supplement (3). Biotin interference gives falsely high or low results in competitive or immunometric immunoassay respectively (4). It may cause falsely raised thyrotropin receptor antibodies (TRAb) as seen in one of our patients. This could lead to a misdiagnosis of Graves' disease. Biotin also interferes with the measurement of testosterone, oestradiol, dehydroepiandrosterone-sulfate (DHEAS), parathyroid hormone, ferritin and thyroglobulin, testosterone, thyroglobulin, leutinizing hormone (LH), follicle stimulating hormone (FSH), sex hormone binding globulin (SHBG), vitamin B12 and folate (4).Clinicians should always interpret laboratory results in the context of patient's clinical state. A high index of clinical suspicion and good collaboration with the laboratory is essential to prevent and detect erroneous results which could otherwise lead to misdiagnosis, unnecessary, expensive additional laboratory and clinical SummaryBiotin or vitamin B7 when ingested in high doses may cause immunoassay interference leading to false potentially misleading results. It is important that clinicians should always interpret laboratory results in the context of patient's clinical state as erroneous results may lead to misdiagnosis and injudicious treatment with adverse patient outcome.

show abstract

Positive and negative interference in immunoassays following biotin ingestion: a pharmacokinetic study

Cited by 78 publications

References 1 publication

Biotina e interferenze nei metodi immunologici; problemi e opportunità

Biotina e interferenze nei metodi immunologici; problemi e opportunità

False biochemical diagnosis of hyperthyroidism in streptavidin-biotin-based immunoassays: the problem of biotin intake and related interferences

Biotin treatment causing erroneous immunoassay results: A word of caution for clinicians

Contact Info

Product

Resources

About