Falsely diagnosed thyrotoxicosis caused by anti-streptavidin antibodies and pre-wash procedures.

Abstract

BACKGROUND:

Anti-streptavidin antibodies are causal determinants of analytical interference during Thyroid function tests, and numerous reports have detailed such interference, with anti-streptavidin antibodies attracting attention.

CASE PRESENTATION:

We conducted a straightforward investigation of interference due to anti-streptavidin antibodies, with a case of a 60-year-old Japanese man who consulted our department for inconsistencies between his clinical course and Thyroid function tests. Experiments were conducted using Cobas8000 e602, which employs assay procedures with pre-wash to evaluate FT4 and FT3 levels.

CONCLUSIONS:

To our knowledge, this is the first published report to clearly investigate such interferences using a combination of polyethylene glycol precipitation, heterophilic blocking tube precipitation, streptavidin-coated magnetic particle precipitation, and different instruments with or without pre-wash. Clinicians should consider that interferences caused by anti-streptavidin antibodies could lead to a misdiagnosis of thyrotoxicosis. Moreover, discussions between laboratory specialists, clinicians, and manufacturers are required to identify interferences and avoid unnecessary examinations and inappropriate treatment.

• Authors: Takuya Ishikawa, Hiroyuki Sakai, Tokutaro Itaya, Suwanai Hirotsugu, Jumpei Shikuma, Takashi Miwa, Ryo Suzuki, Masato Odawara
• Journal: Thyroid research (Thyroid Res) Vol. 14 Issue 1 Pg. 17 (Jul 10 2021) ISSN: 1756-6614 [Print] England
• PMID: 34246285 (Publication Type: Journal Article)
• Copyright: © 2021. The Author(s).