Evidence map›Paper›PMID 39529983›Full record

ArticleArchives of endocrinology and metabolism2024

PTH immunoassay interference: differential diagnosis with normocalcemic primary hyperparathyroidism?

Monique Nakayama Ohe, Roberto Massao Takimoto, Claudia M Aparecida de Francischi Ferrer, Jose Viana Lima, Rosa Paula Biscolla, José Gilberto Henriques Vieira, Maria Izabel Chiamolera

Abstract readCase Reports
In one paragraph

Article in Archives of endocrinology and metabolism, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

7 authors.

Monique Nakayama OheUniversidade Federal de São Paulo Escola Paulista de Medicina Departamento de Endocrinologia e Metabolismo São PauloSP Brasil Departamento de Endocrinologia e Metabolismo, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.ORCID https://orcid.org/0000-0003-4900-7185
Roberto Massao TakimotoGrupo Fleury Departamento de Endocrinologia São PauloSP Brasil Departamento de Endocrinologia, Grupo Fleury, São Paulo, SP, Brasil.ORCID https://orcid.org/0009-0000-3530-9997
Claudia M Aparecida de Francischi FerrerUniversidade Federal de São Paulo Escola Paulista de Medicina Departamento de Cirurgia de Cabeça e Pescoço São PauloSP Brasil Departamento de Cirurgia de Cabeça e Pescoço, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.ORCID https://orcid.org/0000-0002-1045-6058
Jose Viana LimaUniversidade Federal de São Paulo Escola Paulista de Medicina Departamento de Cirurgia de Cabeça e Pescoço São PauloSP Brasil Departamento de Cirurgia de Cabeça e Pescoço, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.ORCID https://orcid.org/0000-0003-3922-4215
Rosa Paula BiscollaUniversidade Federal de São Paulo Escola Paulista de Medicina Departamento de Endocrinologia e Metabolismo São PauloSP Brasil Departamento de Endocrinologia e Metabolismo, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.ORCID https://orcid.org/0000-0003-4358-6622
José Gilberto Henriques VieiraUniversidade Federal de São Paulo Escola Paulista de Medicina Departamento de Endocrinologia e Metabolismo São PauloSP Brasil Departamento de Endocrinologia e Metabolismo, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.ORCID https://orcid.org/0000-0002-7121-4458
Maria Izabel ChiamoleraUniversidade Federal de São Paulo Escola Paulista de Medicina Departamento de Endocrinologia e Metabolismo São PauloSP Brasil Departamento de Endocrinologia e Metabolismo, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.ORCID https://orcid.org/0000-0002-9606-2841

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The main diagnostic dilemma in normocalcemic hyperparathyroidism is differentiating this condition from secondary hyperparathyroidism and other causes of elevated parathyroid hormone (PTH) levels in eucalcemic patients, including potential assay interferences. Despite the analytical sensitivity of immunoassays, they may lack adequate accuracy due to several analytical interferences, such as the presence of heterophilic antibodies. Immunoassays for PTH measurement use the immunometric "sandwich" technique, and only a few cases of interference with this assay have been reported to date. We describe herein two patients in whom PTH immunoassay interference was demonstrated. Both patients presented high serum PTH levels, measured using a second-generation Roche electrochemiluminescence assay (ECLIA; Elecsys Roche, Germany), and normocalcemia. When immunoassay interference was suspected, PTH measurements were repeated using a different analytical platform, the 1-84 PTH third-generation Roche Elecsys ECLIA, resulting in normal levels. We subsequently performed serial dilutions using normal mouse serum with the second-generation ECLIA and found no linearity, indicating the presence of interference in both patients. Immunoassay interference may lead to misinterpretation of a patient's results by the laboratory and incorrect treatment planning by the attending physician. Despite its rarity, the presence of interferences in the PTH immunoassay resulting in falsely high PTH levels should be considered when the laboratory result does not match the patient's clinical presentation, thus preventing erroneous diagnoses and unnecessary therapeutic procedures.

Indexed as

Hyperparathyroidism, PrimaryParathyroid HormoneCalciumDiagnosis, DifferentialHumansImmunoassayLuminescent MeasurementsCalciumParathyroid Hormone

Identifiers

PMID39529983
PMCPMC11554362

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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.