open access

Ahead of print
Brief communication
Submitted: 2021-08-19
Accepted: 2021-08-19
Published online: 2021-10-22
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Experimental study on abnormal thyroid function in patients with Hashimoto's Thyroiditis caused by interference of thyroid hormone autoantibodies

Xiaofang Zhang1, Wenli Feng2, Zuoliang Dong1
DOI: 10.5603/EP.a2021.0090
Affiliations
  1. Department of Clinical laboratory, Tianjin Medical University General Hospital, No.154 Anshan Road, Heping District, 300052 Tianjin, China
  2. Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No.154 Anshan Road, Heping District, 300052, Tianjin, China

open access

Ahead of print
Short communication
Submitted: 2021-08-19
Accepted: 2021-08-19
Published online: 2021-10-22

Abstract

Introduction: Thyroid hormone autoantibody (THAAb) is one of the important factors affecting the measurement of thyroid function. By studying the results of a patient suffered with Hashimoto's thyroiditis, we fully communicated with the clinician, looked for reasons, and achieved the purpose of restoring the truth and sorting out solutions. Material and Methods: During routine examination by ADVIA-Centaur XP system, we found the test of a case was inconsistent with her clinical manifestations, with abnormal elevation of free thyroxine (FT4) that did not conform to the rule of the hypothalamic-pituitary-thyroid axis. Then, different platforms and demonstration of THAAbs with polyethylene glycol (PEG) precipitation were performed to eliminate the influence of THAAbs. Results: The results showed that the thyroid function of the patient was consistent with the clinical manifestations and conformed to the law of the hypothalamic-pituitary-thyroid axis at Architect-i2000sr platform and Roche-Cobas-601 system. The content of FT4 was significantly reduced and lower than the normal reference range, after the patients' serum was treated with PEG, which was in line with the clinical practice. The serum THAAb titer of the patients was nearly 100 times higher than that of the control group. Conclusions: Once the thyroid function of the patients do not conform to their own laws and clinical manifestations, laboratory staff should consider the interference of THAAbs. It is necessary to change the detection platform and retest the serum after PEG treatment while communicating with the clinicians, which is of great significance to provide a true and accurate result to clinicians and patients.

Abstract

Introduction: Thyroid hormone autoantibody (THAAb) is one of the important factors affecting the measurement of thyroid function. By studying the results of a patient suffered with Hashimoto's thyroiditis, we fully communicated with the clinician, looked for reasons, and achieved the purpose of restoring the truth and sorting out solutions. Material and Methods: During routine examination by ADVIA-Centaur XP system, we found the test of a case was inconsistent with her clinical manifestations, with abnormal elevation of free thyroxine (FT4) that did not conform to the rule of the hypothalamic-pituitary-thyroid axis. Then, different platforms and demonstration of THAAbs with polyethylene glycol (PEG) precipitation were performed to eliminate the influence of THAAbs. Results: The results showed that the thyroid function of the patient was consistent with the clinical manifestations and conformed to the law of the hypothalamic-pituitary-thyroid axis at Architect-i2000sr platform and Roche-Cobas-601 system. The content of FT4 was significantly reduced and lower than the normal reference range, after the patients' serum was treated with PEG, which was in line with the clinical practice. The serum THAAb titer of the patients was nearly 100 times higher than that of the control group. Conclusions: Once the thyroid function of the patients do not conform to their own laws and clinical manifestations, laboratory staff should consider the interference of THAAbs. It is necessary to change the detection platform and retest the serum after PEG treatment while communicating with the clinicians, which is of great significance to provide a true and accurate result to clinicians and patients.

Get Citation

Keywords

Hashimoto' s thyroiditis; Thyroid function; Thyroid hormone autoantibody; Free thyroxine 4

About this article
Title

Experimental study on abnormal thyroid function in patients with Hashimoto's Thyroiditis caused by interference of thyroid hormone autoantibodies

Journal

Endokrynologia Polska

Issue

Ahead of print

Article type

Brief communication

Published online

2021-10-22

DOI

10.5603/EP.a2021.0090

Keywords

Hashimoto's thyroiditis
Thyroid function
Thyroid hormone autoantibody
Free thyroxine 4

Authors

Xiaofang Zhang
Wenli Feng
Zuoliang Dong

References (9)
  1. Kricka L. Interferences in Immunoassay—Still a Threat. Clin Chem. 2000; 46(8): 1037–1038.
  2. Sakata S, Matsuda M, Ogawa T, et al. Prevalence of thyroid hormone autoantibodies in healthy subjects. Clin Endocrinol (Oxf). 1994; 41(3): 365–370.
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  5. Fahie-Wilson M, Halsall D. Polyethylene glycol precipitation: proceed with care. Ann Clin Biochem. 2008; 45(Pt 3): 233–235.
  6. Mills F, Jeffery J, Mackenzie P, et al. An immunoglobulin G complexed form of thyroid-stimulating hormone (macro thyroid-stimulating hormone) is a cause of elevated serum thyroid-stimulating hormone concentration. Ann Clin Biochem. 2013; 50(Pt 5): 416–420.
  7. Lee MiNa, Lee SY, Hur KY, et al. Thyroxine (T4) Autoantibody Interference of Free T4 Concentration Measurement in a Patient With Hashimoto's Thyroiditis. Ann Lab Med. 2017; 37(2): 169–171.
  8. Ismail AAA. A radical approach is needed to eliminate interference from endogenous antibodies in immunoassays. Clin Chem. 2005; 51(1): 25–26.
  9. Jones AM, Honour JW. Unusual results from immunoassays and the role of the clinical endocrinologist. Clin Endocrinol (Oxf). 2006; 64(3): 234–244.

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