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Clinical Chemistry 44: 1980-1985, 1998;
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(Clinical Chemistry. 1998;44:1980-1985.)
© 1998 American Association for Clinical Chemistry, Inc.

Case Report

False increase in C-reactive protein attributable to heterophilic antibodies in two renal transplant patients treated with rabbit antilymphocyte globulin

Jean-François Benoist1, Daniel Orbach2, and Daniel Biou1,a

1 Service de Biochimie-Hormonologie, Centre Hospitalier Robert Debre, 75019 Paris, France.

2 Service de Nephrologie, Centre Hospitalier Robert Debre, 75019 Paris, France.
a Author for correspondence. Fax (33) 01 40 03 47 90; e-mail daniel.adrbp{at}wanadoo.fr.

Increased serum C-reactive protein (sCRP) is a sensitive marker of renal graft rejection. We describe the cases of two children with uncomplicated renal transplantation who had false-positive sCRP values on analyzers using rabbit anti-CRP but values within the reference range with anti-CRP from other animal species. Cross-reaction with heterophilic antibodies was suggested by clinical and biological signs of serum sickness and daily treatment with rabbit antilymphocyte globulin (ALG). The interference depended on the serum concentration of the cross-reactant and was removed by subtotal IgG adsorption to Protein A or Protein G or by immunoadsorption using rabbit ALG or total IgG in non-immune rabbit serum. Anti-rabbit IgG and IgM antibodies were detected in both patients. These are the first reported cases of cross-reaction with heterophilic antibodies in a turbidimetric CRP assay.


Key Words: CRP, C-reactive protein • ALG, antilymphocyte globulin • HARA, human anti-rabbit antibody.




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