Thyroxine autoantibody interference is an uncommon cause of inappropriate TSH secretion using the Immulite 2000 assay

Glendenning, Paul; Siriwardhana, Deepani; Hoad, Kirsten; Musk, Alexander A.

doi:10.1016/j.cca.2009.02.002

Cited by 7 publications

(3 citation statements)

References 14 publications

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“…Autoantibodies to thyroid hormones may lead to abnormal levels of free thyroid hormones (fT3 and fT4) by interference with the one-step assay tests (6,12,13). Thyroid hormone antibody interferences are difficult to predict and can occur even with frequently used and wellcharacterized methods (14,15).…”

Section: Discussionmentioning

confidence: 99%

Circulating Antibodies to T4 Causing Discordant Tests of Thyroid Function: A Case Report

Elbüken¹,

Karaca²,

Tanrıverdi³

et al. 2014

tjem

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Section: Discussionmentioning

confidence: 99%

Circulating Antibodies to T4 Causing Discordant Tests of Thyroid Function: A Case Report

Elbüken¹,

Karaca²,

Tanrıverdi³

et al. 2014

tjem

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“…Discordant results on multiple platforms may represent FDH, transthyretin variants, thyroid hormone resistance, thyroid hormone autoantibodies or, rarely, TSH-secreting pituitary adenomas. 3,4 An ESI-TOF-MS method was developed locally to screen for FDH and transthyretin variants. 5 Arg218His is the most widespread FDH variant and has previously been detected…”

Section: Discussionmentioning

confidence: 99%

Discordant thyroid function tests—beware of albumin variants

Li,

Elston,

Moore

et al. 2024

NZMJ

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amilial dysalbuminaemic hyperthyroxinaemia (FDH) is a benign euthyroid condition caused by albumin variants with increased binding affinity for thyroxine (T4). FDH falsely elevates T4 by common indirect/analogue methods confounding patient diagnosis. 1,2 Uncommonly, FDH may be present in a patient with Graves' disease, as seen in the case below, making interpretation of tests used for monitoring difficult.

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“…Unfortunately T4-AAs were not measured. In human patients thyroid hormone-AA interference is a possible, but extremely rare cause of falsely elevated T3 and T4 measurements with modern CLIAs (Glendenning and others 2009, Massart and others 2009). …”

Section: Discussionmentioning

confidence: 99%

Spuriously high thyroid hormone concentrations measured by chemiluminescent immunoassay attributable to anti‐iodothyronine antibodies in a dog

Zeugswetter

Hittmair

Patzl

2016

Vet Record Case Reports

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A 2.5-year-old female English setter was presented with clinicopathological findings suggestive of hypothyroidism. Thyroid-stimulating hormone (TSH: 4.3 ng/ml, normal <0.5), but also free thyroxine (FT4: 77 pmol/l, normal 7.7–48), total thyroxine (67 nmol/l, normal 17–58) and total triiodothyronine (8.7 nmol/l, normal 0.3–3.2) measured with a chemiluminescent immunoassay (CLIA) were elevated. Further investigations revealed oval-shaped hypoechoic thyroid glands characteristic of thyroiditis and very high titres for thyroglobulin autoantibodies, T4 autoantibodies and T3 autoantibodies. As expected the FT4 concentration determined by equilibrium dialysis (ED) to exclude analyte-dependent interferences was low. With levothyroxine therapy clinical signs disappeared and the concentrations of TSH and FT4 (ED) were within the respective reference intervals again. This case demonstrates that anti-thyroid hormone antibodies can cause erroneous CLIA readings, and that their presence should be clarified if thyroid hormone results do not match the clinical presentation or are discordant with TSH results.

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Thyroxine autoantibody interference is an uncommon cause of inappropriate TSH secretion using the Immulite 2000 assay

Cited by 7 publications

References 14 publications

Circulating Antibodies to T4 Causing Discordant Tests of Thyroid Function: A Case Report

Circulating Antibodies to T4 Causing Discordant Tests of Thyroid Function: A Case Report

Discordant thyroid function tests—beware of albumin variants

Spuriously high thyroid hormone concentrations measured by chemiluminescent immunoassay attributable to anti‐iodothyronine antibodies in a dog

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