Open AccessWhat makes D‐dimer assays suspicious–heterophilic antibodies?
Author(s) -
Wu Ying,
Xiao YingXiu,
Huang TengYi,
Zhang XianYan,
Zhou HuanBing,
Zhang XueXuan,
Wu YingE
Publication year - 2019
Publication title -
journal of clinical laboratory analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.536
H-Index - 50
eISSN - 1098-2825
pISSN - 0887-8013
DOI - 10.1002/jcla.22687
Subject(s) - antibody , dimer , d dimer , false positive paradox , interference (communication) , medicine , chemistry , immunology , computer science , artificial intelligence , organic chemistry , computer network , channel (broadcasting)
Background Heterophilic antibodies are still an important source of interference in immunoassays, but reports of interference with D‐dimers are rare. Are D‐dimer level abnormalities, found in the clinic, caused by heterophilic antibodies as well, or are other mechanisms involved? We will elaborate on this issue through two different examples in this article. Methods Serum from two patients with significantly elevated levels of D‐dimers were measured and compared by different methods, diluted, and dealt with heterophilic antibody blockers. At the same time, to retrieve the interference, we focused on the cause of D‐dimer false positives and made a systematic review of the literature. Results The D‐dimer values were normal (0.49 and 0.15 μg/mL) detected with different testing method and decreased after addition of heterophilic antibody blocking reagent. According to literature data, there were 66.7% (4/6) references showed the interference were heterophilic antibody. Conclusions The influence of heterophilic antibodies on the measurement of D‐dimers remains a big challenge. Different measuring instruments and methods may have significant differences in the measurement of D‐dimers. By using a combination of instrumental methods for measuring, incorporating heterophilic antibody blockers, and combining with clinical performance and imaging data, most of the interference can be eliminated.