Evidence map›Paper›PMID 30702570›Full record

ArticleMedicine2019

Falsely elevated thyroglobulin and calcitonin due to rheumatoid factor in non-relapsing thyroid carcinoma: A case report.

Gelsy Arianna Lupoli, Livia Barba, Antonietta Liotti, Evelina La Civita, Roberta Lupoli, Enrico Riccio, Giuseppe Portella, Pietro Formisano, Francesco Beguinot, Daniela Terracciano

Open access · goldAbstract readCase Reports
In one paragraph

Article in Medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Guideline
  2. Article
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  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Gelsy Arianna LupoliDepartment of Clinical Medicine and Surgery.
Livia BarbaDepartment of Clinical Medicine and Surgery.
Antonietta LiottiDepartment of Translational Medical Sciences.
Evelina La CivitaDepartment of Translational Medical Sciences.
Roberta LupoliDepartment of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Italy.
Enrico RiccioDepartment of Clinical Medicine and Surgery.
Giuseppe PortellaDepartment of Translational Medical Sciences.
Pietro FormisanoDepartment of Translational Medical Sciences.
Francesco BeguinotDepartment of Translational Medical Sciences.
Daniela TerraccianoDepartment of Translational Medical Sciences.
University of Naples Federico II · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

rationaleThyroglobulin (Tg) is an accurate indicator of clinical outcome after total thyroidectomy in patients with differentiated thyroid carcinoma. Usually, Tg levels agree with whole body scan. However, in some patient, discordant results were found, often because of Tg immunoassay interference. Several reports indicated that 2-site immunoassay interference with heterophile antibodies (HAb) can lead to misinterpretation of the laboratory test result. PATIENT CONCERNS: We report a case of a 46-year-old woman referred to our endocrine clinic for markedly increased calcitonin (CT) without the associated clinical picture. The measurement was repeated with the same patient sample on a different analytical platform and the result was an undetectable CT level. The measurement of Tg was repeated on 3 different analytical platforms using chemiluminescence and electrochemiluminescence immunoassays and the results were different on each platform. HAb blocking tubes resulted in a different level of both CT and Tg, suggesting the presence of a heterophile substance in the serum sample. Further characterization showed reactivity to several animal species antibodies and an elevated level of the rheumatoid factor (RF). DIAGNOSES: She was diagnosed as papillary thyroid carcinoma.

interventionsShe had undergone thyroidectomy with lymph node dissection and radioactive therapy. OUTCOMES: She was found not to have recurrence despite a high serum Tg level. LESSONS: Our report illustrates a rare case of falsely elevated tumor markers levels due to assay interference caused by RF. This finding pointed out the importance of close communication between the clinician and laboratory staff in order to bring to light discordance between laboratory test results and clinical picture and avoid unnecessary diagnostic procedures and overtreatment.

Indexed as

Antibodies, HeterophileCalcitoninFemaleHumansMiddle AgedRheumatoid FactorThyroglobulinThyroid Cancer, PapillaryThyroidectomyThyroid NeoplasmsAntibodies, HeterophileCalcitoninRheumatoid FactorThyroglobulin

Identifiers

PMID30702570
PMCPMC6380811
OpenAlexW2914990904

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.