Case Study

Cardiac troponin T quantitative assay failure as a result of antibody interference

Philip H. Fortgens, Fierdoz Omar
African Journal of Laboratory Medicine | Vol 2, No 1 | a23 | DOI: https://doi.org/10.4102/ajlm.v2i1.23 | © 2013 Philip H. Fortgens, Fierdoz Omar | This work is licensed under CC Attribution 4.0
Submitted: 09 December 2011 | Published: 03 December 2013

About the author(s)

Philip H. Fortgens, Department of Clinical Laboratory Sciences, Division of Chemical Pathology, University of Cape Town and National Health Laboratory Service, Groote Schuur Hospital, South Africa
Fierdoz Omar, Department of Clinical Laboratory Sciences, Division of Chemical Pathology, University of Cape Town and National Health Laboratory Service, Groote Schuur Hospital, South Africa


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Abstract

Background: Immunoassays are prone to interference by various substances which may cause inaccurate results. This type of interference is difficult to detect analytically.

Objective: A case of CARDIAC Troponin T Quantitative reader (Roche Diagnostics) assayfailure was detected and investigated in order to ascertain the likely cause.

Method: Patient whole blood was mixed with cardiac troponin T-positive blood, patient and control sera were denuded of immunoglobulin G by protein A-affinity chromatographyand patient sera were mixed with mouse serum. Samples were analysed on a CARDIAC Troponin T Quantitative reader.

Results: A mixture of patient whole blood and cardiac troponin T-positive blood resultedin assay failure; removal of immunoglobulin G from patient sera reversed the cardiactroponin T assay failure; the addition of mouse serum as a heterophile antibody blocking agent had no effect.

Conclusion: It is proposed that the interference resulting in assay failure may not be because of a heterophile antibody, but rather a result of a circulating autoantibody to cardiactroponin T, which may compete with antibody assay reagents for binding sites.


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