| Wrong biochemistry results: two case reports and observational study in 5310 patients on potentially misleading thyroid-stimulating hormone and gonadotropin immunoassay results. | |
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MedLine Citation:
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PMID: 12406989 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Immunoassays are used in almost all medical and surgical specialties, but they suffer from interference from proteins such as antibodies in some patients' sera. Such interferences are usually reported in the literature only as case reports after the introduction of a new assay. METHODS: We undertook a prospective observational study on 5310 patients for whom the common immunoassay tests for thyroid-stimulating hormone (TSH) and/or gonadotropins were requested. All TSH and gonadotropin results were critically assessed for a mismatch between the clinical details and analytical results to identify samples suspected of analytical unreliability. These were tested further by three approaches to screen for interference. RESULTS: From the 5310 sets of results, 59 patients' samples were identified as suspect and were tested further. Analytically incorrect results were found in 28 (0.53% of the total studied). The magnitude of interference varied, but in 23 of 28 patients (82%), it was considered large enough to have a potentially adverse effect on cost and/or the clinical care of these patients. Two cases, described in detail, illustrate the adverse effect of error on patient care and cost, and the second highlights the difficulties and limitations of current approaches for identifying interference and inaccuracy in immunoassays. CONCLUSIONS: Because millions of TSH/gonadotropin tests are carried out in UK hospital laboratories alone, our data suggest that thousands of patients could be adversely affected by errors from interferences. Early identification of interference in cases with unusual results could be valuable. |
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Authors:
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Adel A A Ismail; Paul L Walker; Julian H Barth; Kryzsztof C Lewandowski; Rick Jones; William A Burr |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Clinical chemistry Volume: 48 ISSN: 0009-9147 ISO Abbreviation: Clin. Chem. Publication Date: 2002 Nov |
Date Detail:
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Created Date: 2002-10-30 Completed Date: 2002-11-07 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9421549 Medline TA: Clin Chem Country: United States |
Other Details:
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Languages: eng Pagination: 2023-9 Citation Subset: IM |
Affiliation:
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Department of Clinical Biochemistry, at Pinderfields General Hospital, Mid Yorkshire Hospitals NHS Trust, Wakefield, West Yorkshire WF1 4DG, United Kingdom. dr.ismail@panp-tr.northy.nhs.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Antibodies, Heterophile / blood False Positive Reactions Female Gonadotropins / blood* Humans Immunoassay Male Middle Aged Prospective Studies Reference Values Thyrotropin / blood* |
| Chemical | |
Reg. No./Substance:
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0/Antibodies, Heterophile; 0/Gonadotropins; 9002-71-5/Thyrotropin |
| Comments/Corrections | |
Comment In:
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Clin Chem. 2002 Nov;48(11):1871-2
[PMID:
12406970
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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