Rheumatoid Factor Interference in a Tacrolimus Immunoassay

被引:29
作者
Barcelo Martin, Bernardi [1 ]
Marquet, Pierre [2 ,3 ]
Maria Ferrer, Joana [4 ]
Castanyer Puig, Bartomeu [1 ]
Barcelo Bennasar, Antonia [1 ]
Riesco Prieto, Maria [1 ]
Fortuny Marques, Regina [5 ]
机构
[1] Hosp Son Dureta, Serv Anal Clin, Palma de Mallorca 07014, Balearic Isl, Spain
[2] Univ Limoges, Fac Med, F-87065 Limoges, France
[3] CHU Limoges, Serv Pharmacol Toxicol, Limoges, France
[4] Hosp Son Dureta, Serv Immunol, Palma de Mallorca 07014, Balearic Isl, Spain
[5] Hosp Son Llatzer, Serv Anal Clin, Palma de Mallorca, Spain
关键词
tacrolimus; heterophile antibodies; rheumatoid factor; HAMA; therapeutic drug monitoring; CARDIAC TROPONIN-I; ARTHRITIS; ANTIBODY;
D O I
10.1097/FTD.0b013e3181c01da1
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
Recently, there has been an interest in the use of tacrolimus for the treatment of rheumatoid arthritis (RA). The role of rheumatoid factor (RF) as a cause of immunoassay interferences is well known. This study is the first to investigate the susceptibility of a tacrolimus immunoassay to interference by RF. Tacrolimus apparent concentrations were determined using the antibody conjugated magnetic immunoassay (ACMIA) run on the Dimension RxL Immunoassay System in 100 randomly selected samples previously submitted for routine diagnostic or monitoring of RA in patients not receiving tacrolimus. Fifty of them had an RF concentration exceeding 100 IU/L and 50 had an RF concentration below 20 IU/L. Samples with tacrolimus apparent whole-blood concentrations above 2.3 ng/mL (limit of quantification of the ACMIA assay alleged by the vendor) were considered as potential false positives. No positive tacrolimus result was found among the 50 samples with serum RF < 20 IU/mL. Among the 50 selected samples from patients with RF > 100 IU/mL (RF range 110-2650 IU/mL), 2 were positive for tacrolimus with ACMIA. In both cases, the pretreatment of these samples with an immunoglobulin blocking agent reduced the apparent tacrolimus concentrations to below the limit of detection. This was confirmed using the alternative and reference tacrolimus assays, both of which reported results below their respective limits of detection. The measured human anti-mouse antibodies levels were found to be elevated. These results show that certain patients with positive RF can have false-positive tacrolimus results using the tacrolimus ACMIA-Flex immunoassay on a Dimension RXL analyzer, which was not the case with 2 other techniques. The interference with the tacrolimus ACMIA results was suppressed after preincubation with an immunoglobulin blocking reagent.
引用
收藏
页码:743 / 745
页数:3
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