Value of Thyroid Peroxidase Antibodies in Neuroimmune Diseases: Analysis of Interference During Treatment with Intravenous Immunoglobulins

Lab Med. 2022 Jul 4;53(4):426-432. doi: 10.1093/labmed/lmac013.

Abstract

Objective: The absence of specific markers can make the diagnosis of neuroimmune disorders difficult, making other biomarkers such as thyroid peroxidase antibodies (TPO-Abs) more relevant. Laboratory tests are susceptible to interference, especially those tests performed using immunoassay techniques. The effect of treatment with human intravenous immunoglobulin (IVIG) on the results of TPO-Abs assays has not been previously characterized.

Materials and methods: We analyzed TPO-Abs levels in 170 children monitored in the neuroimmune disease department of a tertiary hospital. We analyzed the characteristics of patients with increased TPO-Abs values and compared their progress with and without treatment.

Results: We found that 97% of patients with elevated TPO-Abs had received IVIG. After withdrawal from IVIG, a mean TPO-Abs decrease of 62.5% at 1 month was observed. The IVIG drug preparation was found to contain 1176 U/mL of TPO-Abs. An interferogram confirmed interference.

Conclusion: It is advisable to measure levels of TPO-Abs before starting immunotherapy and remain vigilant regarding possible interference in the event of unsubstantiated elevations of this analyte.

Keywords: autoimmune; immunoassay; interference; interferogram; nonspecific human intravenous immunoglobulin; thyroid peroxidase antibodies.

MeSH terms

  • Autoantibodies* / blood
  • Biomarkers / blood
  • Child
  • Humans
  • Immunoglobulins, Intravenous* / therapeutic use
  • Iodide Peroxidase* / immunology
  • Neuroinflammatory Diseases* / diagnosis
  • Neuroinflammatory Diseases* / therapy

Substances

  • Autoantibodies
  • Biomarkers
  • Immunoglobulins, Intravenous
  • Iodide Peroxidase