Interferences with thyroid function immunoassays: clinical implications and detection algorithm.

Interferences with thyroid function immunoassays: clinical implications and detection algorithm. Endocr Rev. 2018 Jul 04;: Authors: Favresse J, Burlacu MC, Maiter D, Gruson D Abstract Current automated immunoassays used to evaluate thyroid function are vulnerable to different types of interference that can impact clinical decision. This review provides a detailed overview of the six main interferences affecting measurements of thyroid-stimulating hormone, free thyroxine and free triiodothyronine, namely macroTSH, biotin, anti-streptavidin antibodies, anti-ruthenium antibodies, thyroid hormone autoantibodies, and heterophilic antibodies. As the prevalence of some of these conditions has been reported to approach 1% and the frequency of testing for thyroid dysfunction is important, the scale of the problem might therefore be tremendous.Potential interferences in thyroid function testing should always be suspected whenever clinical or biochemical discrepancies arise. Their identification usually relies on additional laboratory tests that include assay method comparison, dilution procedures, blocking reagents studies, and polyethylene glycol precipitation. Based on the pattern of thyroid function test alterations, we propose a detection algorithm to screen for the six above-mentioned interferences.The review also aims at evaluating the clinical impact of thyroid interference on immunoassays, which has not been widely studied so far. Thro...
Source: Endocrine Reviews - Category: Endocrinology Tags: Endocr Rev Source Type: research