嗜异性抗体干扰ACTH检测结果的4例临床病例分析并文献复习

Four cases with heterophile antibodies interferences in the measurement of an adrenocorticotropic hormone and literatures review

4例无特殊临床表现的肾上腺意外瘤患者入院后评估肾上腺功能均正常,采用酶化学发光法检测血清促肾上腺皮质激素(ACTH)结果异常升高(14.3~94.6 pmol/L,正常范围1.1~10.1 pmol/L),改用电化学发光法检测同一血清标本,ACTH的结果均在正常或接近正常(0.80~5.72 pmol/L,正常范围1.6~13.9 pmol/L),前者的血清ACTH浓度为后者的5.5~68.3倍,考虑为嗜异性抗体(HA)干扰检测所致。因此,当内分泌激素检测结果与临床表现显著不符时,应警惕HA的存在,需更换不同的检测方法进一步验证。

Four patients of adrenal incidentaloma without any clinical manifestations were admitted to evaluate adrenal function. All of the adrenal hormones were normal. But the serum adrenocorticotropic hormones (ACTH) markedly elevated (14.3-94.6 pmol/L, normal range 1.1-10.2 pmol/L) with enzyme chemiluminescence. While nearly normal (0.80-5.72 pmol/L) with electrochemiluminescence(normal range 1.6-13.9 pmol/L). The level of serum ACTH of former was range from 5.5 to 68.3 as much as that of the latter. It is considered that the existence of heterophile antibodies(HA) accounts for such remarkable difference between these two methods. The results enlightened that the influence of HA should be thought of when patient′s hormone levels do not fit their clinical manifestations.