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Falsely Elevated Thyroid-Stimulating Hormone (TSH) Level Due to Macro-TSH

机译:宏观TSH导致甲状腺刺激激素(TSH)水平错误升高

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摘要

We encountered a 60-year-old woman with remarkably elevated thyroid-stimulating hormone (TSH) level as measured by electrochemiluminescent immunoassay (ECLIA), but with no specific symptoms, and with normal levels of free T3 and free T4. We performed the following investigations: polyethylene glycol (PEG) precipitation test, human anti-mouse IgG antibody (HAMA) interference test, and 3 additional TSH measurements by chemiluminescent immunoassay (CLIA). We then performed 2 gel filtration chromatography (GFC) procedures; one was at pH 7.2, and the other was at pH 3.0. Although the recovery of TSH shown by the PEG precipitation test was 4% which was extremely low, no HAMA interference was observed. Moreover, 3 CLIA instruments also showed various high values. The first GFC showed that the main peak of TSH immunoreactivity by ECLIA was located at a slightly larger molecular weight position than that of IgG. By the second GFC, the sample from the peak fraction of the first GFC showed that the TSH peak disappeared completely at the previous retention time but newly appeared at the same retention time as the TSH monomer. Protein G-Agarose gel removed the majority of the TSH complex. In conclusion, the majority of TSH in her serum was macro-TSH; TSH and an-ti-TSH IgG autoantibody complex. We should keep the possibility of macro-TSH in mind in cases with unexpectedly high TSH values, especially in autoimmune thyroidal disorders.
机译:我们遇到了一位60岁的女性,通过电化学发光免疫分析法(ECLIA)测得的甲状腺刺激激素(TSH)水平明显升高,但没有任何特定症状,并且游离T3和游离T4的水平正常。我们进行了以下研究:聚乙二醇(PEG)沉淀测试,人抗小鼠IgG抗体(HAMA)干扰测试,以及通过化学发光免疫分析(CLIA)进行的3次其他TSH测量。然后,我们进行了2次凝胶过滤层析(GFC)程序;一个在pH 7.2,另一个在pH 3.0。尽管通过PEG沉淀试验显示TSH的回收率是4%,这是非常低的,但是没有观察到HAMA干扰。此外,三种CLIA仪器也显示出各种高价值。第一个GFC显示ECLIA产生的TSH免疫反应性的主峰位于比IgG稍大的分子量位置。通过第二个GFC,来自第一个GFC峰部分的样品显示,TSH峰在先前的保留时间完全消失,但在与TSH单体相同的保留时间新出现。蛋白G-琼脂糖凝胶去除了大部分TSH复合物。总之,她血清中的大部分TSH是大TSH。 TSH和抗TSH IgG自身抗体复合物。如果TSH值出乎意料的高,尤其是自身免疫性甲状腺疾病,我们应牢记宏观TSH的可能性。

著录项

  • 来源
    《Endocrine journal》 |2009年第3期|435-440|共6页
  • 作者单位

    Division of Diabetology, Metabolism and Endocrinology, The Third Department of Internal Medicine, Tokyo Medical University, Tokyo, Japan;

    Division of Diabetology, Metabolism and Endocrinology, The Third Department of Internal Medicine, Tokyo Medical University, Tokyo, Japan;

    Central Clinical Laboratory, Tokyo Medical University, Tokyo, Japan;

    CD Marketing, Roche Diagnostics K.K. Tokyo, Japan;

    Division of Diabetology, Metabolism and Endocrinology, The Third Department of Internal Medicine, Tokyo Medical University, Tokyo, Japan;

  • 收录信息 美国《科学引文索引》(SCI);美国《化学文摘》(CA);
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

    macro-TSH; anti-TSH autoantibody; IgG; interference; ECLIA;

    机译:宏TSH;抗TSH自身抗体;IgG;干扰;ECLIA;
  • 入库时间 2022-08-18 01:33:45

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