Experimental study on abnormal thyroid function in patients with Hashimoto’s thyroiditis caused by interference of thyroid hormone autoantibodies
Abstract
Introduction: Thyroid hormone autoantibody (THAAb) is one of the important factors affecting thyroid function measurement. By analyzing the examination of a patient suffered with Hashimoto's thyroiditis, we sought to find a correct assessment method.
Material and methods: Radioimmunoassay, chemiluminescence immunoassay on an ADVIA Centaur XP system and Architect i2000sr platform, and electrochemiluminescence immunoassay on a Roche Cobas 601 system were used for detecting thyroid function. Polyethylene glycol (PEG) precipitation were performed to eliminate the influence of THAAbs.
Results: The results showed that the patient’s thyroid function 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: Considering an abnormal thyroid function examination, it is necessary for laboratory staff to retest samples on different platforms. It is of great significance to provide a true and accurate result to clinicians and patients.
Keywords: Hashimoto’s thyroiditisthyroid functionthyroid hormone autoantibodyfree thyroxine 4
References
- Kricka L. Interferences in Immunoassay—Still a Threat. Clin Chem. 2000; 46(8): 1037–1038.
- Sakata S, Matsuda M, Ogawa T, et al. Prevalence of thyroid hormone autoantibodies in healthy subjects. Clin Endocrinol (Oxf). 1994; 41(3): 365–370.
- Sakata S, Nakamura S, Miura K. Autoantibodies against thyroid hormones or iodothyronine. Implications in diagnosis, thyroid function, treatment, and pathogenesis. Ann Intern Med. 1985; 103(4): 579–589.
- Després N, Grant A. Antibody interference in thyroid assays: a potential for clinical misinformation. Clin Chem. 1998; 44(3): 440–454.
- Fahie-Wilson M, Halsall D. Polyethylene glycol precipitation: proceed with care. Ann Clin Biochem. 2008; 45(Pt 3): 233–235.
- 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.
- 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.
- Ismail AAA. A radical approach is needed to eliminate interference from endogenous antibodies in immunoassays. Clin Chem. 2005; 51(1): 25–26.
- Jones AM, Honour JW. Unusual results from immunoassays and the role of the clinical endocrinologist. Clin Endocrinol (Oxf). 2006; 64(3): 234–244.
