An illustration of the clinical relevance of detecting human antimouse antibody interference by affinity chromatography.
Elevated Cancer antigen 125 (CA 125) serum concentrations (up to 221 kU/1) were measured in a 39 year old woman with a positive family history of breast cancer. The serum determinations were performed with the automated Immulite OM-MA chemiluminescent enzyme immunoassay system (Diagnostic Products). Laparoscopic evaluation of the ovaries did not reveal any abnormalities. CA 125 measurements in the same patient using the automated IMx immunoassay system (Abbott) demonstrated normal serum levels. Using a previously reported chromatography procedure IgG type human antimouse antibody activity was found to be present in the serum samples explaining the falsely elevated levels. To prevent this interference the manufacturer modified the assay system by replacing the monoclonal M11 detection antibody with a rabbit polyclonal antibody. Using the modified OM-MA CA 125 assay results were comparable with the IMx values.
Koper
N P
NP
Department of Obstetrics and Gynaecology, University Hospital Nijmegen, The Netherlands.
Massuger
L F
LF
Thomas
C M
CM
Beyer
C
C
Crooy
M J
MJ
D000328:Adult; D000888:Antibodies, Anti-Idiotypic / Q000097:blood; D000915:Antibody Affinity; D001943:Breast Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000235:genetics; D018394:CA-125 Antigen / Q000097:blood*; D002846:Chromatography, Affinity; D003951:Diagnostic Errors; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007118:Immunoassay; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D010535:Laparoscopy; D011933:Reagent Kits, Diagnostic
D000888:Antibodies, Anti-Idiotypic; D018394:CA-125 Antigen; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D011933:Reagent Kits, Diagnostic