4.7 Article

False positive in the measurement of thyroglobulin induced by rheumatoid factor

Journal

CLINICA CHIMICA ACTA
Volume 447, Issue -, Pages 43-46

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ELSEVIER
DOI: 10.1016/j.cca.2015.04.039

Keywords

Thyroglobulin; Interference; Heterophilic antibodies; Rheumatoid factor; Differentiated thyroid cancer

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Background: We report a case of interference in thyroglobulin (Tg) measurement in a woman with differentiated thyroid cancer and rheumatoid arthritis history. Due to discordant Tg in relation to TSH concentrations and negative images, we investigated possible interference in the measurement of Tg. Methods: During the follow-up we measured Tg by chemiluminescence (TgQL) using Immulite 2000 immunoassay system. To investigate possible interference in Tg measurement, we made serial dilutions, re-testing of Tg by an alternative method: electrochemiluminescence, Cobas 6000 analyzer (TgEQL), recovery test of Tg and polyethylene glycol (PEG) 6000 precipitation. Results: During the patient follow-up, the TgQL ranged between <0.3 and 16.1 ng/ml. In the evaluated serum samples very high titers of rheumatoid factor (RF) were found. When RF titers were lowered post PEG precipitation, Tg QL concentrations became undetectable. Conclusion: We describe an unusual case of interference in Tg assay due to RR When disagreement among Tg concentrations, images and clinical features is observed, we suggest taking into account the evaluation of possible Tg interference to avoid unnecessary complementary exams and inappropriate treatment. (C) 2015 Elsevier B.V. All rights reserved.

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