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Articles |
Antibody to Escherichia coli Produces False-Positive Results in Multiple Immunometric Assays
Divisions of
1
Laboratory Medicine and
2
Surgical Pathology, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110.
a Author for correspondence. Fax 314-362-1461; e-mail mscott{at}labmed.wustl.edu
Background: Interferences in immunometric assays as a result of human anti-immunoglobulin antibodies frequently have been described in the literature. The etiology of these interfering antibodies is usually not known but has been associated with rheumatoid factors in some assays. It is known that microorganisms in experimental settings can induce anti-immunoglobulin antibodies.
Methods: Following Escherichia coli septicemia, a
56-year-old male patient had increased immunoassay results for cardiac
troponin I, thyrotropin, human chorionic gonadotropin,
-fetoprotein, and CA-125 that were consistent with myocardial
infarction, hyperthyroidism, and pregnancy, and suggestive of an occult
neoplasm such as hepatic or ovarian cancer. None of these diagnoses
were consistent with the rest of his medical exam. In addition, the
patient had a restricted IgM 
paraprotein by immunofixation. Plasma
from the patient was incubated with Sepharose-conjugated protein A,
irrelevant murine monoclonal antibodies, and formalin-killed E.
coli organisms from his infection to determine whether these
immunoassay values were falsely increased.
Results: Incubation of the patient’s plasma with
irrelevant murine monoclonal antibodies or the E. coli
organism produced normal immunoassay values and removed the IgM
paraprotein.
Conclusions: The patient produced a very restricted IgM
antibody response to the E. coli infection that had
anti-immunoglobulin activity and caused falsely increased values in
numerous immunometric assays. Microorganism-induced anti-immunoglobulin
antibodies are discussed in the context of this patient.
The following articles in journals at HighWire Press have cited this article:
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  B E Fritz, R J Hauke, and D F Stickle New onset of heterophilic antibody interference in prostate-specific antigen measurement occurring during the period of post-prostatectomy prostate-specific antigen monitoring Ann Clin Biochem, May 1, 2009; 46(3): 253 - 256. [Abstract] [Full Text] [PDF]
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 A. A.A. Ismail A Radical Approach Is Needed to Eliminate Interference from Endogenous Antibodies in Immunoassays Clin. Chem., January 1, 2005; 51(1): 25 - 26. [Full Text] [PDF]
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 C. Roongsritong, I. Warraich, and C. Bradley Common Causes of Troponin Elevations in the Absence of Acute Myocardial Infarction: Incidence and Clinical Significance Chest, May 1, 2004; 125(5): 1877 - 1884. [Abstract] [Full Text] [PDF]
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R. Sapin, A. Agin, and F. Gasser Misleading High Thyrotropin Results Obtained with a Two-Site Immunometric Assay Involving a Chimeric Antibody Clin. Chem., May 1, 2004; 50(5): 946 - 948. [Full Text] [PDF]
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 C. M. Preissner, D. J. O'Kane, R. J. Singh, J. C. Morris, and S. K. G. Grebe Phantoms in the Assay Tube: Heterophile Antibody Interferences in Serum Thyroglobulin Assays J. Clin. Endocrinol. Metab., July 1, 2003; 88(7): 3069 - 3074. [Abstract] [Full Text] [PDF]
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F. Flourie, F. Parant, M. C. Penes, and D. Alcaraz-Galvain Falsely Increased Thyroid-stimulating Hormone Concentrations attributable to Interference from Human Anti-mouse Antibodies Clin. Chem., December 1, 2002; 48(12): 2289 - 2289. [Full Text] [PDF]
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A. A.A. Ismail, P. L. Walker, J. H. Barth, K. C. Lewandowski, R. Jones, and W. A. Burr Wrong Biochemistry Results: Two Case Reports and Observational Study in 5310 Patients on Potentially Misleading Thyroid-stimulating Hormone and Gonadotropin Immunoassay Results Clin. Chem., November 1, 2002; 48(11): 2023 - 2029. [Abstract] [Full Text] [PDF]
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W. J. Kim, O. F. Laterza, K. G. Hock, J. F. Pierson-Perry, D. M. Kaminski, M. Mesguich, F. Braconnier, R. Zimmermann, M. Zaninotto, M. Plebani, et al. Performance of a Revised Cardiac Troponin Method That Minimizes Interferences from Heterophilic Antibodies Clin. Chem., July 1, 2002; 48(7): 1028 - 1034. [Abstract] [Full Text] [PDF]
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 A. A. Ismail and J. H Barth Wrong biochemistry results BMJ, September 29, 2001; 323(7315): 705 - 706. [Full Text] [PDF]
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L. J. Kricka Interferences in Immunoassay--Still a Threat Clin. Chem., August 1, 2000; 46(8): 1037 - 1038. [Full Text] [PDF]
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