An erytropoietin measurement difficult to interpret

AUTORI

Elena Gentile¹, Maria Luisa De Angelis¹, Anna Rosa Corno¹, Alessandra Romandini¹, Rosanna Cavaleri¹, Annamaria Crippa¹, Romano Danesi^1,2 ¹Laboratorio Specialistico – Patologia Clinica – Sostanze d’abuso. ASST Grande Ospedale Metropolitano Niguarda ²Dipartimento di Oncologia e Emato-Oncologia, Università degli Studi di Milano

ABSTRACT

Erythropoietin (EPO) regulates red blood cell production and is mainly produced in the peritubular cells of the adult kidney in response to a decrease in tissue oxygenation. EPO determination is requested in cases of reduced or increased erythrocyte production. Laboratory assays used to measure EPO in human serum are mainly based on enzyme-linked immunosorbent assays (ELISA). ELISA results, however, may be affected by the presence of heterophile antibodies. We report a case of analytical interference in EPO measurement.

BIBLIOGRAFIA

Wauthier L, Plebani M, Favresse J. Interferences in immunoassays: review and practical algorithm. Clin Chem Lab Med 2022;60:808-20.
Jacobson Lo, Goldwasser E, Fried W, Plzak L. Role of the kidney in erythropoiesis. Nature 1957;179:633-4.
Elliott S, Pham E, Macdougall IC. Erythropoietins: a common mechanism of action. Exp Hematol 2008;36:1573-84
Koury MJ, Bondurant MC. The mechanism of erythropoietin action. Am J Kidney Dis 1991;18 Suppl 1:20-3.
Marsden JT. Erythropoietin, measurement and clinical applications. Ann Clin Biochem 2006;43:97-104
Morton A. When lab tests lie … heterophile antibodies. Aust Fam Physician 2014;43:391-3.
Zhang J, Xu L, Qiao L. Falsely elevated serum estradiol in woman of reproductive age led to unnecessary intervention and delayed fertility opportunity: a case report and literature review. BMC Womens Health 2022;22:232.
Altinier S, Varagnolo M, Zaninotto M, Boccagni P, Plebani M. Heterophilic antibody interference in a non-endogenous molecule assay: an apparent elevation in the tacrolimus concentration. Clin Chim Acta 2009;402:193-5.
Vanderstichele H, Stoops E, Vanmechelen E, Jeromin A. Potential sources of interference on Abeta immunoassays in biological samples. Alzheimers Res Ther. 2012;4:39.
Sturgeon CM, Viljoen A. Analytical error and interference in immunoassay: minimizing risk. Ann Clin Biochem 2011;48:418-32.
Bolstad N, Warren DJ, Nustad K. Heterophilic antibody interference in immunometric assays. Best Pract Res Clin Endocrinol Metab 2013;27:647-61.
Marcolla A, Dilberis C, Dal Bosco F, Amadori P. Impatto clinico e laboratoristico delle isoforme macromolecolari della prolattina, RIMeL – IJLaM 2005;2:123-9.