Interferences With Thyroid Function Immunoassays: Clinical Implications and Detection Algorithm

Favresse, Julien; Burlacu, Maria-Cristina; Maiter, Dominique; Gruson, Damien

doi:10.1210/er.2018-00119

Cited by 258Clinical Laboratory Practices and Quality ControlThyroid Disorders and TreatmentsThyroid and Parathyroid Surgery

Interferences With Thyroid Function Immunoassays: Clinical Implications and Detection Algorithm

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Favresse, Julien, Burlacu, Maria-Cristina, Maiter, Dominique, Gruson, Damien·2018·Endocrine Reviews

DOI 10.1210/er.2018-00119

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Abstract

Automated immunoassays used to evaluate thyroid function are vulnerable to different types of interference that can affect clinical decisions. This review provides a detailed overview of the six main types of interference known to affect measurements of thyroid stimulating hormone (TSH), free thyroxine (T4) and free triiodothyronine (T3): macro-TSH, biotin, antistreptavidin antibodies, anti-ruthenium antibodies, thyroid hormone autoantibodies, and heterophilic antibodies. Because the prevalence of some of these conditions has been reported to approach 1% and the frequency of testing for thyroid dysfunction is important, the scale of the problem might be tremendous. Potential interferences in thyroid function testing should always be suspected whenever clinical or biochemical discrepancies arise. Their identification usually relies on additional laboratory tests, including assay method comparison, dilution procedures, blocking reagents studies, and polyethylene glycol precipitation. Based on the pattern of thyroid function test alterations, to screen for the six aforementioned types of interference, we propose a detection algorithm, which should facilitate their identification in clinical practice. The review also evaluates the clinical impact of thyroid interference on immunoassays. On review of reported data from more than 150 patients, we found that ≥50% of documented thyroid interferences led to misdiagnosis and/or inappropriate management, including prescription of an unnecessary treatment (with adverse effects in some situations), inappropriate suppression or modification of an ongoing treatment, or use of unnecessary complementary tests such as an I123 thyroid scan. Strong interaction between the clinician and the laboratory is necessary to avoid such pitfalls.

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Rarely, more extreme analytical errors are present in thyroid testing.
“Rarely, more extreme analytical errors are present137 (Table 5).”
From Thyroid Stimulating Hormone and Thyroid Hormones (Triiodothyronine and Thyroxine): An American Thyroid Association-Commissioned Review of Current Clinical and Laboratory Status (2023) · cites this paper as [137]
A number of medications can affect thyroid function tests by interfering with the synthesis, transport, and metabolism of TSH and thyroid hormones and by interfering with thyroid function immunoassays.
“A number of medications can affect the thyroid function tests not only by interfering with the synthesis, transport, and metabolism of TSH and thyroid hormones but also by interfering with thyroid function immunoassays (30, 37–40) ( Table 1 ).”
From Levothyroxine therapy in elderly patients with hypothyroidism (2021) · cites this paper as [38]
Assay variability, potential interference with rheumatoid factors or heterophilic antibodies, occasional cases of macro-TSH, the age-related shift towards higher TSH concentrations in older iodine-sufficient patients, and obesity may affect this population-based sample to an extent.
“Furthermore, assay variability, potential interference with rheumatoid factors or heterophilic antibodies, occasional cases of macro-TSH, the observed age related shift towards higher TSH concentrations in older iodine sufficient patients, and obesity may affect this population based sample to an extent.45 46 47 48”
From Thyroid replacement therapy, thyroid stimulating hormone concentrations, and long term health outcomes in patients with hypothyroidism: longitudinal study (2019) · cites this paper as [45]
Immunoassay platforms have limitations; interference from biotin, thyroid hormone autoantibodies, heterophilic antibodies, antistreptavidin antibodies, anti-ruthenium antibodies, and heterophilic antibodies can occur.
“It is worth highlighting that whilst immunoassay platforms are currently the method of choice for the measurement of thyroid function tests [116], there are limitations; as well as macro-TSH, interference from biotin, thyroid hormone autoantibodies, heterophilic antibodies, antistreptavidin antibodies, anti-ruthenium antibodies, and heterophilic antibodies can occur [116].”
From Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice (2023) · cites this paper as [116]
Immunoassay platforms are currently the method of choice for the measurement of thyroid function tests.
“It is worth highlighting that whilst immunoassay platforms are currently the method of choice for the measurement of thyroid function tests [116], there are limitations; as well as macro-TSH, interference from biotin, thyroid hormone autoantibodies, heterophilic antibodies, antistreptavidin antibodies, anti-ruthenium antibodies, and heterophilic antibodies can occur [116].”
From Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice (2023) · cites this paper as [116]

Low free T4 combined with inappropriately low or normal TSH is also frequent in several other situations where treatment is not required, e.g. due to heterophilic antibodies or other interfering factors.
“Low free T4 combined with inappropriately low or normal TSH is also frequent in several other situations where treatment is not required, e.g.due to heterophilic antibodies or other interfering factors in the serum of the patient/person under study (Favresse et al., 2018).”
From The hypothalamus-pituitary-thyroid (HPT)-axis and its role in physiology and pathophysiology of other hypothalamus-pituitary functions (2021) · cites this paper as Favresse et al., 2018
Biotin, antistreptavidin antibodies, antiruthenium antibodies, and thyroid hormone autoantibodies provide other sources of interference with the TSH test that may lead to an aberrant result.
“Biotin, antistreptavidin antibodies, antiruthenium antibodies, and thyroid hormone autoantibodies provide other sources of interference with the TSH test that may lead to an aberrant result [36].”
From Challenges in Interpreting Thyroid Stimulating Hormone Results in the Diagnosis of Thyroid Dysfunction (2019) · cites this paper as [36]
Immunoassay platforms can be affected by interferences that may lead to incorrect clinical decisions.
“Immunoassay platforms can be susceptible to interferences, potentially leading to incorrect clinical decisions.”
From Refractory hypothyroidism: unraveling the complexities of diagnosis and management (2023) · cites this paper as [81]
Macro-TSH interference should be suspected when TSH is isolated and elevated, typically above 10 mUI/L, with thyroid hormones in the upper normal range and no clinical thyroid dysfunction.
“Suspecting macro-TSH interference is advised with isolated TSH elevation (typically higher than 10 mUI/L) and thyroid hormones within the upper normal range, without clinical evidence of thyroid dysfunction.”
From Refractory hypothyroidism: unraveling the complexities of diagnosis and management (2023) · cites this paper as [81]
Anti-T4 and anti-T3 autoantibodies, present in 40% of autoimmune thyroid disease cases, can cause falsely elevated hormone levels.
“Anti-T4 and anti-T3 autoantibodies, found in 40% of autoimmune thyroid disease cases, can lead to false hormone elevations”
From Refractory hypothyroidism: unraveling the complexities of diagnosis and management (2023) · cites this paper as [81]
Biotin at doses above 1.5 mg/day can cause falsely low TSH and elevated free T4 and free T3, with the effect depending on the assay platform and avoidable by a washout period.
“Biotin (in doses higher than 1.5 mg/d) can cause falsely low TSH levels and elevated fT4 and fT3, with its impact depending on the platform used, and being avoided with a washout period.”
From Refractory hypothyroidism: unraveling the complexities of diagnosis and management (2023) · cites this paper as [81]
Heterophilic antibody interference can produce both low and high measurements, with elevated values being more common.
“interference from heterophilic antibodies can result in both low and high measures, with elevated values being more common.”
From Refractory hypothyroidism: unraveling the complexities of diagnosis and management (2023) · cites this paper as [81]

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Research works printed but not linked: 2

McMahon RJ. Biotin in metabolism and molecular biology. Annu Rev Nutr. 2002;22(1):221-239.
Ranaivosoa MK, Ganel S, Agin A, Romain S, Parent X, Reix N. Chronic kidney failure and biotin: a combination inducing unusual results in thyroid and parathyroid investigations, report of 2 cases [in French]. Nephrol Ther. 2017;13(7):553-558.

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Hyperthyroidism
Lee, S. Y., & Pearce, E. N. (2023) · JAMA · doi:10.1001/jama.2023.19052 · Cited by 335 · see citing works
Nonspecific Binding—Fundamental Concepts and Consequences for Biosensing Applications
Frutiger, A., Tanno, A., Hwu, S., Tiefenauer, R. F., Vörös, J., & Nakatsuka, N. (2021) · Chemical Reviews · doi:10.1021/acs.chemrev.1c00044 · Cited by 282 · see citing works
Hyperthyroidism: aetiology, pathogenesis, diagnosis, management, complications, and prognosis
Wiersinga, W. M., Poppe, K. G., & Effraimidis, G. (2023) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(23)00005-0 · Cited by 254 · see citing works
D-dimer: Preanalytical, analytical, postanalytical variables, and clinical applications
Favresse, J., Lippi, G., Roy, P., Châtelain, B., Jacqmin, H., Cate, H. T., & Mullier, F. (2018) · Critical Reviews in Clinical Laboratory Sciences · doi:10.1080/10408363.2018.1529734 · Cited by 215 · see citing works
The hypothalamus-pituitary-thyroid (HPT)-axis and its role in physiology and pathophysiology of other hypothalamus-pituitary functions
Feldt-Rasmussen, U., Effraimidis, G., & Klose, M. (2021) · Molecular and Cellular Endocrinology · doi:10.1016/j.mce.2021.111173 · Cited by 170 · see citing works
Drug effects on the thyroid.
Burch, H. B. (2019) · New England Journal of Medicine · doi:10.1056/nejmra1901214 · Cited by 164 · see citing works
Thyroid replacement therapy, thyroid stimulating hormone concentrations, and long term health outcomes in patients with hypothyroidism: longitudinal study
Thayakaran, R., Adderley, N. J., Sainsbury, C., Torlinska, B., Boelaert, K., Šumilo, D., Price, M., Thomas, G. N., Toulis, K. A., & Nirantharakumar, K. (2019) · BMJ · doi:10.1136/bmj.l4892 · Cited by 138 · see citing works
Hormone Immunoassay Interference: A 2021 Update
Ghazal, K., Brabant, S., Prié, D., & Piketty, M. (2021) · Annals of Laboratory Medicine · doi:10.3343/alm.2022.42.1.3 · Cited by 130 · see citing works
Interferences in immunoassays: review and practical algorithm
Wauthier, L., Plebani, M., & Favresse, J. (2022) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2021-1288 · Cited by 125 · see citing works
A 2019 update on TSH-secreting pituitary adenomas
Beck-Peccoz, P., Giavoli, C., & Lania, A. (2019) · Journal of Endocrinological Investigation · doi:10.1007/s40618-019-01066-x · Cited by 111 · see citing works
Errors within the total laboratory testing process, from test selection to medical decision-making – A review of causes, consequences, surveillance and solutions
Mrazek, C., Keppel, M. H., Cadamuro, J., Haschke‐Becher, E., Oberkofler, H., Felder, T. K., & Lippi, G. (2020) · Biochemia Medica · doi:10.11613/bm.2020.020502 · Cited by 114 · see citing works
Thyroid Stimulating Hormone and Thyroid Hormones (Triiodothyronine and Thyroxine): An American Thyroid Association-Commissioned Review of Current Clinical and Laboratory Status
Van Uytfanghe, K., Ehrenkranz, J., Halsall, D., Hoff, K., Loh, T. P., Spencer, C. A., Köhrle, J., & ATA Thyroid Function Tests Writing Group (2023) · Thyroid® · doi:10.1089/thy.2023.0169 · Cited by 100 · see citing works
“136 Rarely, more extreme analytical errors are present 137 (Table 5).”
Background
Challenges in Interpreting Thyroid Stimulating Hormone Results in the Diagnosis of Thyroid Dysfunction
Razvi, S., Bhana, S., & Mrabeti, S. (2019) · Journal of Thyroid Research · doi:10.1155/2019/4106816 · Cited by 90 · see citing works
“Biotin, antistreptavidin antibodies, antiruthenium antibodies, and thyroid hormone autoantibodies provide other sources of interference with the TSH test that may lead to an aberrant result [36].”
Background
Bioreceptors as the key components for electrochemical biosensing in medicine
Wang, X., Zhou, J., & Wang, H. (2024) · Cell Reports Physical Science · doi:10.1016/j.xcrp.2024.101801 · Cited by 97 · see citing works
Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice
Taylor, P. N., Lansdown, A., Witczak, J., Khan, R., Rees, A., Dayan, C. M., & Okosieme, O. (2023) · Thyroid Research · doi:10.1186/s13044-023-00149-5 · Cited by 72 · see citing works
“implications It is worth highlighting that whilst immunoassay platforms are currently the method of choice for the measurement of thyroid function tests [116], there are limitations; as well as macro-TSH, interference from biotin, thyroid hormone autoantibodies, heterophilic antibodies, antistreptavidin antibodies, an…”
Background
Best practices in mitigating the risk of biotin interference with laboratory testing
Bowen, R. A. R., Benavides, R., Colón-Franco, J. M., Katzman, B. M., Muthukumar, A., Sadrzadeh, H. S. M., Straseski, J. A., Klause, U., & Tran, N. K. (2019) · Clinical Biochemistry · doi:10.1016/j.clinbiochem.2019.08.012 · Cited by 66 · see citing works
Thyroid hormone system disrupting chemicals
Köhrle, J., & Frädrich, C. (2021) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2021.101562 · Cited by 67 · see citing works
Levothyroxine therapy in elderly patients with hypothyroidism
Effraimidis, G., Watt, T., & Feldt-Rasmussen, U. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.641560 · Cited by 60 · see citing works
Antibody-mediated interferences affecting cardiac troponin assays: recommendations from the IFCC Committee on Clinical Applications of Cardiac Biomarkers
Hammarsten, O., Warner, J., Lam, L., Kavsak, P. A., Lindahl, B., Aakre, K. M., Collinson, P. O., Jaffe, A. S., Saenger, A. K., Body, R. M., et al. (2023) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2023-0028 · Cited by 59 · see citing works
2024 European Thyroid Association Guidelines on diagnosis and management of genetic disorders of thyroid hormone transport, metabolism and action
Persani, L., Rodien, P., Moran, C., Visser, W., Groeneweg, S., Peeters, R. P., Refetoff, S., Gurnell, M., Beck-Peccoz, P., & Chatterjee, K. (2024) · European Thyroid Journal · doi:10.1530/etj-24-0125 · Cited by 39 · see citing works
MANAGEMENT OF ENDOCRINE DISEASE Subclinical hypothyroidism in children
Salerno, M., Improda, N., & Capalbo, D. (2020) · European Journal of Endocrinology · doi:10.1530/eje-20-0051 · Cited by 52 · see citing works
D-dimer testing: A narrative review
Wauthier, L., Favresse, J., Hardy, M. J., Douxfils, J., Gal, G. L., Roy, P., van Es, N., Ay, C., Cate, H. T., Lecompte, T., et al. (2023) · Advances in clinical chemistry · doi:10.1016/bs.acc.2023.02.006 · Cited by 49 · see citing works
Interpretation of common endocrine laboratory tests: technical pitfalls, their mechanisms and practical considerations
Haddad, R. A., Giacherio, D. A., & Barkan, A. L. (2019) · Clinical Diabetes and Endocrinology · doi:10.1186/s40842-019-0086-7 · Cited by 47 · see citing works
Biotin interference in assays for thyroid hormones, thyrotropin and thyroglobulin
Ylli, D., Soldin, S. J., Stolze, B., Wei, B., Nigussie, G., Nguyen, H., Mendu, D. R., Mete, M., Wu, D., Gomes-Lima, C. J., et al. (2021) · Thyroid · doi:10.1089/thy.2020.0866 · Cited by 44 · see citing works
Laboratory Thyroid Tests: A Historical Perspective
Spencer, C. A. (2023) · Thyroid · doi:10.1089/thy.2022.0397 · Cited by 33 · see citing works
Kidney disease and thyroid dysfunction: the chicken or egg problem
Echterdiek, F., Ranke, M. B., Schwenger, V., Heemann, U. W., & Latus, J. (2022) · Pediatric Nephrology · doi:10.1007/s00467-022-05640-z · Cited by 31 · see citing works
Approach to the Patient With Raised Thyroid Hormones and Nonsuppressed TSH
Moran, C., Schoenmakers, N. A., Halsall, D. J., Oddy, S., Lyons, G., van den Berg, S. A. A., Gurnell, M., & Chatterjee, K. (2023) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgad681 · Cited by 29 · see citing works
Mutational Landscape of Resistance to Thyroid Hormone Beta (RTHβ)
Concolino, P., Costella, A., & Paragliola, R. M. (2019) · Molecular Diagnosis & Therapy · doi:10.1007/s40291-019-00399-w · Cited by 29 · see citing works
Macro vitamin B12: an underestimated threat
Soleimani, R., Favresse, J., Roy, T., Gruson, D., & Fillée, C. (2019) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2019-0999 · Cited by 29 · see citing works
Independent and combined effects of biotin and hemolysis on high-sensitivity cardiac troponin assays
Harley, K., Bissonnette, S., Inzitari, R., Schulz, K. M., Apple, F. S., Kavsak, P. A., & Gunsolus, I. L. (2021) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2021-0124 · Cited by 28 · see citing works
Free thyroxine measurement in clinical practice: how to optimize indications, analytical procedures, and interpretation criteria while waiting for global standardization
D’Aurizio, F., Kratzsch, J., Gruson, D., Ovčariček, P. P., & Giovanella, L. (2022) · Critical Reviews in Clinical Laboratory Sciences · doi:10.1080/10408363.2022.2121960 · Cited by 31 · see citing works
Understanding and managing interferences in clinical laboratory assays: the role of laboratory professionals
Zaninotto, M., & Plebani, M. (2019) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2019-0898 · Cited by 25 · see citing works
Thyroid Hormone Abuse in Elite Sports: The Regulatory Challenge
Gild, M. L., Stuart, M. C., Clifton-Bligh, R. J., Kinahan, A., & Handelsman, D. J. (2022) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgac223 · Cited by 26 · see citing works
Biotin interference: evaluation of a new generation of electrochemiluminescent immunoassays for high-sensitive troponin T and thyroid-stimulating hormone testing
Mzougui, S., Favresse, J., Soleimani, R., Fillée, C., & Gruson, D. (2020) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2020-0214 · Cited by 24 · see citing works
Risks of suboptimal and excessive thyroid hormone replacement across ages
Feldt-Rasmussen, U., Effraimidis, G., Bliddal, S., & Klose, M. (2023) · Journal of Endocrinological Investigation · doi:10.1007/s40618-023-02229-7 · Cited by 23 · see citing works
Familial Dysalbuminemic Hyperthyroxinemia: An Underdiagnosed Entity
Dieu, X., Bouzamondo, N., Briet, C., Illouz, F., Moal, V., de Casson, F. B., Bouhours‐Nouet, N., Reynier, P., Coutant, R., Rodien, P., et al. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9072105 · Cited by 23 · see citing works
Subclinical hypothyroidism in children: updates for pediatricians
Metwalley, K. A., & Farghaly, H. S. (2021) · Annals of Pediatric Endocrinology & Metabolism · doi:10.6065/apem.2040242.121 · Cited by 23 · see citing works
Methods for analyzing positive cardiac troponin assay interference
Hammarsten, O., Becker, C., & Engberg, A. E. (2023) · Clinical Biochemistry · doi:10.1016/j.clinbiochem.2023.03.004 · Cited by 23 · see citing works
Familial dysalbuminaemic hyperthyroxinaemia interferes with current free thyroid hormone immunoassay methods
Khoo, S. S. K., Lyons, G., McGowan, A., Gurnell, M., Oddy, S., Visser, W. E., van den Berg, S. A. A., Halsall, D. J., Taylor, K., Chatterjee, K., et al. (2020) · European Journal of Endocrinology · doi:10.1530/eje-19-1021 · Cited by 22 · see citing works
Macro-TSH: A Diagnostic Challenge
Larsen, C. B., Petersen, E. R. B., Overgaard, M., & Bonnema, S. J. (2020) · European Thyroid Journal · doi:10.1159/000509184 · Cited by 21 · see citing works
Management of thyroid dysfunctions in the elderly. French Endocrine Society consensus statement 2019. Long version
Goichot, B., Raverot, V., Klein, M., Racaru, L. V., Payrat, J. A.-D., Lairez, O., Leroy, R., Cailleux, A., Wolff, P., Groussin, L., et al. (2020) · Annales d Endocrinologie · doi:10.1016/j.ando.2020.04.010 · Cited by 18 · see citing works
Artificial intelligence and thyroid disease management
Gruson, D., Stankovic, S. D., Macq, B. M. M., Bernardini, S., Gouget, B., Homšak, E., & Dabla, P. K. (2022) · Biochemia Medica · doi:10.11613/bm.2022.020601 · Cited by 18 · see citing works
Percentile transformation and recalibration functions allow harmonization of thyroid-stimulating hormone (TSH) immunoassay results
Padoan, A., Clerico, A., Zaninotto, M., Trenti, T., Tozzoli, R., Aloe, R., Alfano, A., Rizzardi, S., Dittadi, R., Migliardi, M., et al. (2020) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2019-1167 · Cited by 19 · see citing works
Laboratory interference in the thyroid function test
Paczkowska, K., Otlewska, A., Loska, O., Kolačkov, K., Bolanowski, M., & Daroszewski, J. (2020) · Endokrynologia Polska · doi:10.5603/ep.a2020.0079 · Cited by 17 · see citing works
Analysis of free, unbound thyroid hormones by liquid chromatography‐tandem mass spectrometry: A mini‐review of the medical rationale and analytical methods
Westbye, A. B., Aas, F. E., Kelp, O., Dahll, L. K., & Thorsby, P. M. (2023) · Analytical Science Advances · doi:10.1002/ansa.202200067 · Cited by 16 · see citing works
Managing symptoms in hypothyroid patients on adequate levothyroxine: a narrative review
Razvi, S., Mrabeti, S., & Luster, M. (2020) · Endocrine Connections · doi:10.1530/ec-20-0205 · Cited by 15 · see citing works
“8%) may interfere directly with a TSH test, providing aberrant results [72].”
Background
An Update on the Pathophysiology and Diagnosis of Inappropriate Secretion of Thyroid-Stimulating Hormone
Ohba, K. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22126611 · Cited by 15 · see citing works
Diagnostic, Theranostic and Prognostic Value of Thyroglobulin in Thyroid Cancer
Giovanella, L., D’Aurizio, F., Ovčariček, P. P., & Görges, R. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13092463 · Cited by 15 · see citing works
The effect of specific binding proteins on immunoassay measurements of total and free thyroid hormones and cortisol
Kanegusuku, A. G., Araque, K., Nguyen, H., Wei, B., Hosseini, S., & Soldin, S. J. (2021) · Therapeutic Advances in Endocrinology and Metabolism · doi:10.1177/2042018821989240 · Cited by 15 · see citing works
Redefinition of Successful Treatment of Patients With Hypothyroidism. Is TSH the Best Biomarker of Euthyroidism?
Fitzgerald, S. P., & Falhammar, H. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.920854 · Cited by 16 · see citing works
Endogenous anti-streptavidin antibodies causing erroneous laboratory results more common than anticipated
Dahll, L. K., Haave, E. M., Dahl, S. R., Aas, F. E., & Thorsby, P. M. (2021) · Scandinavian Journal of Clinical and Laboratory Investigation · doi:10.1080/00365513.2020.1858493 · Cited by 15 · see citing works
Heterophilic antibody interference with TSH measurement on different immunoassay platforms
Cheng, X., Guo, X., Chai, X., Hu, Y., Lian, X., & Zhang, G. (2021) · Clinica Chimica Acta · doi:10.1016/j.cca.2020.11.018 · Cited by 14 · see citing works
Assessment of thyroid function tests and harmonization: opinion on thyroid hormone harmonization
Araque, K. A., Klubo-Gwiezdzinska, J., Nieman, L. K., Welsh, K., & Soldin, S. J. (2019) · Therapeutic Advances in Endocrinology and Metabolism · doi:10.1177/2042018819897049 · Cited by 14 · see citing works
A case of macro-TSH consisting of IgA-bound TSH
Fukushita, M., Watanabe, N., Noh, J. Y., Yoshihara, A., Matsumoto, M., Suzuki, N., Yoshimura, R., Sugino, K., & Ito, K. (2021) · Endocrine Journal · doi:10.1507/endocrj.ej21-0021 · Cited by 14 · see citing works
Thyroglobulin Assay Interferences: Clinical Usefulness of Mass-Spectrometry Methods
Barbesino, G., Algeciras‐Schimnich, A., & Bornhorst, J. A. (2022) · Journal of the Endocrine Society · doi:10.1210/jendso/bvac169 · Cited by 14 · see citing works
Impact of subclinical hypothyroidism on health‐related quality of life: a narrative review
Danicic, J. M., Inder, W. J., & Kotowicz, M. A. (2021) · Internal Medicine Journal · doi:10.1111/imj.15431 · Cited by 15 · see citing works
Unusual causes of hyperthyrotropinemia and differential diagnosis of primary hypothyroidism: a revised diagnostic flowchart
Campi, I., Dell’Acqua, M., Stellaria Grassi, E., Cristina Vigone, M., & Persani, L. (2023) · European Thyroid Journal · doi:10.1530/etj-23-0012 · Cited by 13 · see citing works
Apparent resistance to thyroid hormones: From biological interference to genetics
Dieu, X., Sueur, G., Moal, V., Boux de Casson, F., Bouzamondo, N., Bouhours, N., Briet, C., Illouz, F., Reynier, P., Coutant, R., et al. (2019) · Annales d'Endocrinologie · doi:10.1016/j.ando.2019.06.005 · Cited by 12 · see citing works
Refractory hypothyroidism: unraveling the complexities of diagnosis and management
Quiroz-Aldave, J. E., Concepción-Zavaleta, M. J., Durand-Vásquez, M. D. C., Concepción-Urteaga, L. A., Gamarra-Osorio, E. R., Suárez-Rojas, J., Rafael-Robles, L. D. P., Paz-Ibarra, J., & Román-González, A. (2023) · Endocrine Practice · doi:10.1016/j.eprac.2023.09.003 · Cited by 14 · see citing works
Management of thyroid dysfunction and thyroid nodules in the ageing patient
Martínez‐Montoro, J. I., Doulatram‐Gamgaram, V. K., Olveira, G., Valdés, S., & Fernández‐García, J. C. (2023) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2023.06.005 · Cited by 13 · see citing works
Large method differences for free thyroid hormone assays in the hyperthyroid range can affect assessment of hyperthyroid status: Comparison of Abbott Alinity to Roche Cobas, Siemens Centaur and equilibrium dialysis LC-MS/MS
Westbye, A. B., Aas, F. E., Dahl, S. R., Zykova, S. N., Kelp, O., Dahll, L. K., & Thorsby, P. M. (2023) · Clinical Biochemistry · doi:10.1016/j.clinbiochem.2023.110676 · Cited by 13 · see citing works
Erroneous thyroid and steroid hormones profile due to anti-streptavidin antibodies
Bayart, J., Favresse, J., Melnik, E., Lardinois, B., Fillée, C., Maiter, D. M., & Gruson, P. D. (2019) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2018-1355 · Cited by 13 · see citing works
The role of laboratory medicine in the diagnosis of the hyperthyroidism
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Predictors of transient congenital primary hypothyroidism: data from the German registry for congenital hypothyroidism (AQUAPE “HypoDok”)
Matejek, N., Tittel, S. R., Haberland, H., Rohrer, T. R., Busemann, E.-M., Jorch, N., Schwab, K., Woelfle, J., Holl, R. W., & Bettendorf, M. (2021) · European Journal of Pediatrics · doi:10.1007/s00431-021-04031-0 · Cited by 13 · see citing works
Biotin interferences: Have we neglected the impact on serological markers?
Bayart, J., Favresse, J., Stoefs, A., Closset, M., Roy, T., Fillée, C., Rodriguez‐Villalobos, H., Kabamba‐Mukadi, B., & Gruson, D. (2020) · Clinica Chimica Acta · doi:10.1016/j.cca.2020.01.012 · Cited by 12 · see citing works
Simple dual-readout immunosensor based on phosphate-triggered and potassium permanganate for visual detection of fenitrothion
Chen, Z., Huang, A.-J., Luo, L. G., Xu, Z.-L., & Wang, H. (2023) · Biosensors and Bioelectronics · doi:10.1016/j.bios.2023.115872 · Cited by 12 · see citing works
Central hypothyroidism related to antipsychotic and antidepressant medications: an observational study and literature review
Keen, F., Chalishazar, A., Mitchem, K., Dodd, A., & Kalhan, A. (2022) · European Thyroid Journal · doi:10.1530/etj-21-0119 · Cited by 12 · see citing works
Approach to the Patient With a Suppressed TSH
Praw, S. S., & Brent, G. A. (2022) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgac635 · Cited by 13 · see citing works
Biological variation and analytical goals of four thyroid function biomarkers in healthy European volunteers
Mairesse, A., Wauthier, L., Courcelles, L., Luyten, U., Burlacu, M., Maisin, D., Favresse, J., van Dievoet, M., & Gruson, D. (2021) · Clinical Endocrinology · doi:10.1111/cen.14356 · Cited by 11 · see citing works
Self-citation
Development of an equilibrium dialysis ID-UPLC-MS/MS candidate reference measurement procedure for free thyroxine in human serum
Ribera, A., Zhang, L., Dabbs‐Brown, A., Sugahara, O., Poynter, K., Uytfanghe, K. V., Shimizu, E., van Herwaarden, A. E., Botelho, J. C., Danilenko, U., et al. (2023) · Clinical Biochemistry · doi:10.1016/j.clinbiochem.2023.03.010 · Cited by 10 · see citing works
Persistently increased vitamin B12 concentration due to cobalamin macrocomplexes: a case report and review of the literature
Delgado, J. A., García, M. I. P., Bauçà, J. M., Mullor, R. V., & Barceló, A. (2020) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2019-1010 · Cited by 10 · see citing works
Inflammation-Related Markers and Thyroid Function Measures in Pediatric Patients: Is the Grade of Obesity Relevant?
Țaranu, I., Lazea, C., Creț, V., Răcătăianu, N., Iancu, M., & Bolboaca, S. D. (2021) · Diagnostics · doi:10.3390/diagnostics11030485 · Cited by 10 · see citing works
Neuroendocrine neoplasms – think about it and choose the most appropriate diagnostic and therapeutic steps
Koch, C. A., & Petersenn, S. (2018) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-018-9472-1 · Cited by 10 · see citing works
Characterization of biotin interference in 21 Vitros 5600 immunoassays and risk mitigation for patient safety at a large academic medical center
Stieglitz, H. M., & Korpi-Steiner, N. L. (2019) · Clinical Biochemistry · doi:10.1016/j.clinbiochem.2019.09.006 · Cited by 9 · see citing works
Immunoassay Interference on Thyroid Function Tests During Treatment with Nivolumab
Paragliola, R. M., Corsello, A., Papi, G., Melfa, E., Urbani, A., Pontecorvi, A., Corsello, S. M., & Carrozza, C. (2020) · Thyroid · doi:10.1089/thy.2019.0799 · Cited by 10 · see citing works
Familial Dysalbuminemic Hyperthyroxinemia as a Cause for Discordant Thyroid Function Tests
Ting, M. J. M., Zhang, R., Lim, E. M., Ward, B. K., Wilson, S. G., & Walsh, J. P. (2021) · Journal of the Endocrine Society · doi:10.1210/jendso/bvab012 · Cited by 9 · see citing works
Recent advances in liquid chromatography‐tandem mass spectrometry for the detection of thyroid hormones and thyroglobulin in clinical samples: A review
Jin, Y., Zhai, T., Wang, Y., Li, J., Wang, T., & Huang, J. (2024) · Journal of Separation Science · doi:10.1002/jssc.202400466 · Cited by 9 · see citing works
Thyrotropin reference interval in older adults
Zhai, X., Li, Y. J., Teng, X., Teng, W., Shi, X., & Shan, Z. (2024) · Endocrine Connections · doi:10.1530/ec-24-0435 · Cited by 9 · see citing works
Circulating Biomarkers of Thyroid Cancer: An Appraisal
Codrich, M., Biasotto, A., & D’Aurizio, F. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14051582 · Cited by 9 · see citing works
Two-site evaluation of the Roche Elecsys Vitamin D total III assay
Favresse, J., Schiettecatte, J., Wolff, F., COTTON, F. J., Elsen, M., Eucher, C., Rosseels, C., & Anckaert, E. (2022) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2022-0177 · Cited by 9 · see citing works
Signal interference between drugs and metabolites in LC-ESI-MS quantitative analysis and its evaluation strategy
Jiang, F., Liu, J., Li, Y., Lu, Z., Liu, Q., Xing, Y., Zhu, J., Huang, M., & Zhong, G. (2024) · Journal of Pharmaceutical Analysis · doi:10.1016/j.jpha.2024.02.008 · Cited by 9 · see citing works
Central hyperthyroidism due to an ectopic TSH-secreting pituitary tumor: a case report and literature review
Zhu, C., Liu, T., Yu, H., Chang, L., Zhang, X., Yao, J., Zhang, G., Chen, Q., He, Q., & Liu, M. R. (2024) · Frontiers in Endocrinology · doi:10.3389/fendo.2024.1301260 · Cited by 9 · see citing works
Abnormal thyroid hormone response to TRH in a case of macro-TSH and the cut-off value for screening cases of inappropriate TSH elevation
Ohba, K., Maekawa, M., Iwahara, K., Suzuki, Y., Matsushita, A., Sasaki, S., Oki, Y., & Nakamura, H. (2019) · Endocrine Journal · doi:10.1507/endocrj.ej19-0320 · Cited by 9 · see citing works
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Authors: Favresse, J., Burlacu, M.-C., Maiter, D., & Gruson, D.
Affiliations: Cliniques Universitaires Saint-Luc (BE)
Corresponding author: Gruson, Damien
ORCID: Favresse, Julien
Burlacu, Maria-Cristina
Maiter, Dominique
Gruson, Damien
Venue: Endocrine Reviews
Publisher: The Endocrine Society
Published: 2018-07-04
Volume: 39
Issue: 5
Pages: 830-850
ISSN: 0163-769X (ISSN-L)
1945-7189
DOI: 10.1210/er.2018-00119
OpenAlex: W2894797166
Cited by: 258
References: 158
Citations by year: 2026: 33 · 2025: 27 · 2024: 20 · 2023: 47 · 2022: 35 · 2021: 36 · 2020: 37 · 2019: 21 · 2018: 2
FWCI: 3.15
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Endocrine Reviews (publishedVersion)
PubMed (publishedVersion)
DIAL (Catholic University of Leuven) (submittedVersion, other-oa)
Funders: Université Catholique de Louvain
Topics: Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Keywords: thyroid function tests, immunoassay interference, thyroid-stimulating hormone, free thyroxine, free triiodothyronine, biotin interference, heterophile antibodies, detection algorithm, misdiagnosis, inappropriate treatment
MeSH terms: Algorithms, Humans, Immunoassay, Sensitivity and Specificity, Thyroid Function Tests, Thyrotropin, Thyroxine, Triiodothyronine

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Interferences With Thyroid Function Immunoassays: Clinical Implications and Detection Algorithm

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