Clinical Review Lesson of the week

Interfering antibodies affecting immunoassays in woman with pet rabbits

BMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7388.541 (Published 08 March 2003) Cite this as: BMJ 2003;326:541
  1. Adrian Park, specialist registrara,
  2. Mark Edwards, specialist registrara,
  3. Mandy Donaldson, principal biochemistb,
  4. Mohammad Ghatei, professora,
  5. Karim Meeran, senior lecturer (k.meeran@ic.ac.uk)a
  1. a Department of Metabolic Medicine, Hammersmith Hospital, London W12 0NN
  2. b Department of Clinical Biochemistry, Hammersmith Hospital, London W12 0HS
  1. Correspondence to: K Meeran
  • Accepted 13 September 2002

Interfering antibodies must be considered when the clinical picture and immunoassay results do not match

Many antibodies used in diagnostic immunoassays are derived from rabbits. Keeping rabbits as pets is known to be a risk factor for developing heterophilic (or interfering) antibodies.1 Studies have shown that 30-40% of the population have heterophilic antibodies.2 However, only about 0.05-0.5% of immunoassays seem to be affected to the extent that the concentration of interfering antibodies overwhelms the assay system.2 We report a case in which the presence of heterophilic antibodies led to unnecessary investigations.

Case history

A 52 year old woman was referred to our hospital in July 2001 for further investigation of persistently raised fasting gut hormones concentrations. She had had irritable bowel syndrome diagnosed 16 years previously. The high concentrations of gut hormones had first been detected nine years ago, when, after an exacerbation of …

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