Assay interference leading to misdiagnosis of central precocious puberty

David G. Segal, Linda DiMeglio, Kenneth W. Ryder, Pamela A. Vollmer, Ora Hirsch Pescovitz

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Immunoassays are widely used to determine hormone levels. Antibodies directed against components of the immunoassay system can interfere with analyte concentration estimates. When unrecognized by clinicians, inappropriate clinical intervention may follow. The case of a young child with premature thelarche and elevated basal and stimulated luteinizing hormone (LH) levels is presented, in whom it is hypothesized that heterophile antibodies (HAs) caused interference in the LH immunoassay. LH concentrations were measured in two different assays: LH-microparticle enzyme immunoassay (MEIA) and LH-immunochemiluminometric assay (ICMA). To detect HA interference, LH level was remeasured after both preincubation with mouse serum to neutralize human anti-mouse antibodies, and treatment with a heterophile-blocking tube. The mean basal LH concentration by LH-MEIA was 7.4 mIU/mL and for LH-ICMA was 0.08 mIU/mL (normal range for age: 0.02-0.3 mIU/mL). LH concentration by MEIA was 0.08 mIU/mL after preincubation with mouse serum and 2.7 mIU/mL after preincubation with a heterophile blocking tube. In conclusion, HAs were identified in the serum of a child with premature thelarche. The presence of HAs led to spuriously elevated basal and gonadotropin-releasing hormone-stimulated LH concentrations, resulting in a diagnosis of central precocious puberty and unnecessary therapy. To avoid similar cases in the future, clinicians should consider the possibility of assay interference when the clinical picture is incongruent with the laboratory data.

Original languageEnglish
Pages (from-to)195-199
Number of pages5
JournalEndocrine
Volume20
Issue number3
DOIs
StatePublished - Apr 2003

Fingerprint

Luteinizing Hormone
Diagnostic Errors
Heterophile Antibodies
Immunoenzyme Techniques
Immunoassay
Central Precocious Puberty
Serum
Gonadotropin-Releasing Hormone
Anti-Idiotypic Antibodies
Reference Values
Hormones
Antibodies

Keywords

  • Gonadotropin-releasing hormone
  • Heterophile antibody
  • Precocious puberty

ASJC Scopus subject areas

  • Endocrinology

Cite this

Segal, D. G., DiMeglio, L., Ryder, K. W., Vollmer, P. A., & Hirsch Pescovitz, O. (2003). Assay interference leading to misdiagnosis of central precocious puberty. Endocrine, 20(3), 195-199. https://doi.org/10.1385/ENDO:20:3:195

Assay interference leading to misdiagnosis of central precocious puberty. / Segal, David G.; DiMeglio, Linda; Ryder, Kenneth W.; Vollmer, Pamela A.; Hirsch Pescovitz, Ora.

In: Endocrine, Vol. 20, No. 3, 04.2003, p. 195-199.

Research output: Contribution to journalArticle

Segal, DG, DiMeglio, L, Ryder, KW, Vollmer, PA & Hirsch Pescovitz, O 2003, 'Assay interference leading to misdiagnosis of central precocious puberty', Endocrine, vol. 20, no. 3, pp. 195-199. https://doi.org/10.1385/ENDO:20:3:195
Segal, David G. ; DiMeglio, Linda ; Ryder, Kenneth W. ; Vollmer, Pamela A. ; Hirsch Pescovitz, Ora. / Assay interference leading to misdiagnosis of central precocious puberty. In: Endocrine. 2003 ; Vol. 20, No. 3. pp. 195-199.
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