- Research Centers
- Reproductive Endocrinology Research Center
- Prevention of Metabolic Disorders Research center
- Nutrition and Endocrine Research Center
- Endocrine Physiology Research Center
- Cellular-Molecular Research Center
- Prevention and Treatment of Obesity Research Center
- Endocrine Research Center
- Research Center for Social Determinants of Health
case-presentation_40
- High Total t4 à increased protein binding of the hormones
- familial dysalbuminemic hyperthyroxinemia
- presence of anti-T4 antibodies.
- High TSH à presence of heterophilic Ab (in immunometric assays)
- These human anti-mouse gamma globulins can bridge the two mouse monoclonal antibodies (solid phase antibody and signal antibody) and cause spuriously elevated readings for TSH [15,20].
- Nonlinearity of TSH measurements with serial dilution of the patient’s serum strongly suggests assay interference.
- Addition of nonimmune homologous mouse immunoglobulins has reduced this type of assay interference. Commercial assays exist for detecting human anti-mouse antibodies (HAMA).
- Patients with substances interfering with TSH measurements are usually euthyroid, not thyrotoxic, and have normal free T4 and T3. Thus, tests for interference with the TSH measurement are rarely required.
