Literature DB >> 28078322

Diagnostic Dilemma in Discordant Thyroid Function Tests Due to Thyroid Hormone Autoantibodies.

Panudda Srichomkwun1, Neal H Scherberg1, Jasminka Jakšić2, Samuel Refetoff3.   

Abstract

OBJECTIVE: Assay interference could be the cause of abnormal thyroid function tests. Early recognition prevents inappropriate patient management. The objective of this report is to present a case with discordant thyroid function tests in different thyroid assay platforms due to thyroid autoantibodies.
METHODS: We present a case her family, laboratory data and methods that investigate immunoassay interference.
RESULTS: A 21-year-old woman with autoimmune thyroid disease was treated for hypothyroidism with levothyroxine and noted to have elevated total and free thyroxine, free triiodothyronine but normal thyroid-stimulating hormone. Repeat thyroid function tests using different platforms revealed discrepant results. Further investigation showed that the patient had positive thyroid hormone autoantibodies (THAAbs).
CONCLUSION: We demonstrates abnormal thyroid function tests caused by THAAbs. The latter were the cause of interference with assays resulting in discrepant test results inconsistent with the clinical presentation. Early recognition would prevent inappropriate patient management.

Entities:  

Keywords:  euthyroid hyperthyroxinemia; thyroid function test; thyroid hormone autoantibodies

Year:  2017        PMID: 28078322      PMCID: PMC5222615          DOI: 10.4158/EP151142.CR

Source DB:  PubMed          Journal:  AACE Clin Case Rep        ISSN: 2376-0605


  10 in total

1.  Autoimmunity in patients with resistance to thyroid hormone.

Authors:  Marla S Barkoff; Masha Kocherginsky; João Anselmo; Roy E Weiss; Samuel Refetoff
Journal:  J Clin Endocrinol Metab       Date:  2010-05-05       Impact factor: 5.958

2.  A radical approach is needed to eliminate interference from endogenous antibodies in immunoassays.

Authors:  Adel A A Ismail
Journal:  Clin Chem       Date:  2004-11-11       Impact factor: 8.327

Review 3.  Unusual results from immunoassays and the role of the clinical endocrinologist.

Authors:  Alison M Jones; John W Honour
Journal:  Clin Endocrinol (Oxf)       Date:  2006-03       Impact factor: 3.478

4.  Influence of thyroid hormone autoantibodies on 7 thyroid hormone assays.

Authors:  Soha A Zouwail; Angela M O'Toole; Penelope M S Clark; Joe P Begley
Journal:  Clin Chem       Date:  2008-05       Impact factor: 8.327

Review 5.  Autoantibodies against thyroid hormones or iodothyronine. Implications in diagnosis, thyroid function, treatment, and pathogenesis.

Authors:  S Sakata; S Nakamura; K Miura
Journal:  Ann Intern Med       Date:  1985-10       Impact factor: 25.391

Review 6.  Antibody interference in thyroid assays: a potential for clinical misinformation.

Authors:  N Després; A M Grant
Journal:  Clin Chem       Date:  1998-03       Impact factor: 8.327

Review 7.  The syndromes of reduced sensitivity to thyroid hormone.

Authors:  Alexandra M Dumitrescu; Samuel Refetoff
Journal:  Biochim Biophys Acta       Date:  2012-08-16

8.  Classification and proposed nomenclature for inherited defects of thyroid hormone action, cell transport, and metabolism.

Authors:  Samuel Refetoff; J H Duncan Bassett; Paolo Beck-Peccoz; Juan Bernal; Gregory Brent; Krishna Chatterjee; Leslie J De Groot; Alexandra M Dumitrescu; J Larry Jameson; Peter A Kopp; Yoshiharu Murata; Luca Persani; Jacques Samarut; Roy E Weiss; Graham R Williams; Paul M Yen
Journal:  J Clin Endocrinol Metab       Date:  2014-03       Impact factor: 5.958

9.  Case report: When measured free T4 and free T3 may be misleading. Interference with free thyroid hormones measurements on Roche® and Siemens® platforms.

Authors:  Krzysztof C Lewandowski; Katarzyna Dąbrowska; Andrzej Lewiński
Journal:  Thyroid Res       Date:  2012-10-29

Review 10.  Pitfalls in the measurement and interpretation of thyroid function tests.

Authors:  Olympia Koulouri; Carla Moran; David Halsall; Krishna Chatterjee; Mark Gurnell
Journal:  Best Pract Res Clin Endocrinol Metab       Date:  2013-10-17       Impact factor: 4.690

  10 in total
  3 in total

1.  High prevalence of thyroid hormone autoantibody and low rate of thyroid hormone detection interference.

Authors:  Jiajia Ni; Yu Long; Li Zhang; Qingqing Yang; Chunjia Kou; Shuqi Li; Jingyi Li; Haiqing Zhang
Journal:  J Clin Lab Anal       Date:  2021-12-01       Impact factor: 2.352

Review 2.  Clinical, Genetic, and Protein Structural Aspects of Familial Dysalbuminemic Hyperthyroxinemia and Hypertriiodothyroninemia.

Authors:  Ulrich Kragh-Hansen; Monica Galliano; Lorenzo Minchiotti
Journal:  Front Endocrinol (Lausanne)       Date:  2017-11-01       Impact factor: 5.555

Review 3.  Hormone Immunoassay Interference: A 2021 Update.

Authors:  Khaldoun Ghazal; Severine Brabant; Dominique Prie; Marie-Liesse Piketty
Journal:  Ann Lab Med       Date:  2022-01-01       Impact factor: 3.464

  3 in total

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