Interpretation of common endocrine laboratory tests: technical pitfalls, their mechanisms and practical considerations

Clinical Diabetes and Endocrinology
Raad A HaddadAriel L Barkan

Abstract

Pitfalls in hormonal assays are commonly seen in clinical practice and may lead to erroneous clinical impressions and treatments. In this article, we address common laboratory pitfalls encountered during evaluation of patients with real or presumed endocrine disorders including high dose hook effect and falsely normal prolactin in cases of macroprolactinomas, macroprolactinemia and falsely elevated prolactin, macrothyrotropinemia and falsely elevated TSH, heterophile antibodies leading to false elevation of hormonal concentration, biotin interference with different hormonal assays, cross-reactivity of steroid hormones immunoassays, and others. We describe the mechanisms of such laboratory pitfalls, review clinical scenarios in which they might occur, and discuss the ways to resolve such conundrums. The aim of this article is to present a learning material for the endocrine trainees and practitioners.

References

Nov 1, 1992·The Journal of Clinical Endocrinology and Metabolism·N HattoriH Kurahachi
Jun 1, 1989·Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie·G I KeitnerW A Brown
Nov 1, 1974·The Journal of Clinical Endocrinology and Metabolism·H K Suh, A G Frantz
Jun 1, 1969·The Journal of Clinical Endocrinology and Metabolism·G E Abraham
Apr 2, 1981·The New England Journal of Medicine·D M MockH Baker
Apr 1, 1995·Scandinavian Journal of Clinical and Laboratory Investigation·T BjøroP Torjesen
Nov 1, 1994·Clinical and Experimental Immunology·E LegouffeJ Brochier
Jul 1, 1997·The Journal of Steroid Biochemistry and Molecular Biology·E S TomlinsonD J Back
Apr 29, 1999·Journal of Endocrinological Investigation·B CavacoV Leite
Nov 14, 2000·Archives of Internal Medicine·M BoscaroN Sonino
Feb 12, 2002·The Journal of Clinical Endocrinology and Metabolism·Sophie Vallette-KasicThierry Brue
Aug 14, 2002·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Todd W FriezeMaureen K Koops
Jul 5, 2003·The Journal of Clinical Endocrinology and Metabolism·Carol M PreissnerStefan K G Grebe
Jul 5, 2003·The Journal of Clinical Endocrinology and Metabolism·Eleni V Dimaraki, Craig A Jaffe
Dec 13, 2003·The Journal of Clinical Endocrinology and Metabolism·G ArnaldiM Boscaro
May 26, 2004·Clinics in Laboratory Medicine·George G Klee
Jun 9, 2004·Clinical Biochemistry·Richard F Roberts, William L Roberts
Nov 13, 2004·The Journal of Nutritional Biochemistry·J Zempleni, D M Mock
Feb 3, 2005·The Journal of Clinical Endocrinology and Metabolism·Naoki HattoriChiyoko Inagaki
Apr 20, 2006·International Journal of Clinical Practice·H Sadideen, R Swaminathan
Aug 18, 2006·Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association·T C Friedman
Nov 9, 2006·The Journal of Clinical Endocrinology and Metabolism·William RosnerHershel Raff
Nov 14, 2006·Postgraduate Medical Journal·S G Santhana KrishnanR K Cobbs
Mar 13, 2008·The Journal of Clinical Endocrinology and Metabolism·Lynnette K NiemanVictor M Montori
Dec 17, 2009·Clinica Chimica Acta; International Journal of Clinical Chemistry·Saori KoshidaNaoki Watanabe
Oct 8, 2013·Best Practice & Research. Clinical Endocrinology & Metabolism·Nils BolstadKjell Nustad
Oct 8, 2013·The Journal of Clinical Endocrinology and Metabolism·D J Handelsman, L Wartofsky
Nov 13, 2014·Clinical Endocrinology·Naoki HattoriAkira Shimatsu
Apr 17, 2015·European Journal of Endocrinology·Angela E TaylorIlpo T Huhtaniemi
May 2, 2015·Clinical Pharmacokinetics·Jacqueline A GibbonsTaoufik Ouatas
Mar 1, 2016·Scandinavian Journal of Clinical and Laboratory Investigation·Shiva MongoluAzraai Nasruddin
May 2, 2016·Clinical Biochemistry·Brian G Keevil
Jan 29, 2017·Clinical Chemistry·Kelly Y Chun
Mar 18, 2017·Clinical Chemistry and Laboratory Medicine : CCLM·Leo Lam, Campbell V Kyle
May 24, 2017·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Shanika SamarasingheEarle W Holmes

❮ Previous
Next ❯

Methods Mentioned

BETA
gel filtration
equilibrium dialysis

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

© 2021 Meta ULC. All rights reserved