A case of spurious hypercalcitoninemia: a cautionary tale on the use of plasma calcitonin assays in the screening of patients with thyroid nodules for neoplasia.
A case of spurious hypercalcitoninemia: a cautionary tale on the use of plasma calcitonin assays in the screening of patients with thyroid nodules for neoplasia.
复制标题
虚假高降钙素血症一例：关于使用血浆降钙素测定筛查甲状腺结节肿瘤患者的警示故事。
DOI：
10.1007/bf03343874
复制
发表时间：
2001
影响因子：
5.4
通讯作者：
Sarlis,NJ
中科院分区：
文献类型：
--
作者：
Uwaifo,GI;Remaley,AT;Stene,M;Reynolds,JC;Yen,PM;Snider,RH;Becker,KL;Sarlis,NJ
在甲状腺结节患者中，血浆CT测量作为甲状腺髓样癌（MTC）的筛查试验具有重要作用。然而，升高的血浆CT水平应在每个个体病例的整体临床表现的背景下进行解释，并在做出治疗决定之前进行仔细验证。我们提出的情况下，17岁的女孩谁是提到我们与甲状腺结节和血浆CT水平升高，通过一个网站RIA不涉及事先血浆提取测量。使用两种不同的方法重新测量血浆CT，即预先提取血浆的RIA和双位点免疫荧光测定法（ICMA），结果非常低或无法检测。随后，使用最初应用的CT RIA重新测定样品;再次发现血浆CT水平升高。这些升高具有假性性质，可能是由于患者血浆中存在不明物质干扰最初使用的RIA中CT的测量所致。我们的病人最终被诊断为桥本甲状腺炎，没有MTC的证据。由于有几种情况可以引起真正的或假的高降钙素血症，我们建议在开始其他广泛的诊断调查或建议甲状腺切除术之前，应至少确认一次血浆CT水平升高。最后，选择的测定应仅检测成熟CT分子。
The measurement of plasma CT has an important role as a screening test for medullary thyroid carcinoma (MTC) in patients with thyroid nodules. However, elevated plasma CT levels should be interpreted within the context of the overall clinical picture in each individual case and carefully validated before therapeutic decisions are made. We present the case of a 17-yrold girl who was referred to us with a thyroid nodule and elevated plasma CT levels, as measured by a one-site RIA not involving prior plasma extraction. Plasma CT was re-measured using two different methods, a RIA with prior plasma extraction and a two-site immunochemiluminometric assay (ICMA), and was either very low or undetectable. Subsequently, samples were re-assayed using the initially applied CT RIA; plasma CT levels were again found to be elevated. These elevations were of a spurious nature, probably caused by the presence of an unidentified substance in the patient’s plasma interfering with the measurement of CT in the initially used RIA. Our patient was eventually diagnosed with Hashimoto’s thyroiditis, and had no evidence of MTC. As several conditions can cause either true or spurious hypercalcitoninemia, we suggest that elevated plasma CT levels should be confirmed at least once before other extensive diagnostic investigations are initiated or thyroidectomy is recommended. Finally, the assay selected should detect only the mature CT molecule.