High-dose biotin therapy leading to false biochemical endocrine profiles: validation of a simple method to overcome biotin interference
Autor: | Marie-Liesse Piketty, Claude Hercend, Jean-Claude Souberbielle, Delphine Bernard, Dominique Prié, Philippe Chanson, Frédéric Sedel |
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Rok vydání: | 2017 |
Předmět: |
Male
medicine.medical_specialty Multiple Sclerosis Clinical Biochemistry Biotin Endocrine System 030204 cardiovascular system & hematology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Liquid chromatography–mass spectrometry Internal medicine medicine Humans Endocrine system Immunoassay Detection limit Dose-Response Relationship Drug medicine.diagnostic_test Chemistry Biochemistry (medical) General Medicine Molecular biology Hormones Prolactin Endocrinology Case-Control Studies Female Streptavidin Artifacts Luteinizing hormone Blood Chemical Analysis 030217 neurology & neurosurgery Hormone |
Zdroj: | Clinical Chemistry and Laboratory Medicine (CCLM). 55:817-825 |
ISSN: | 1437-4331 1434-6621 |
Popis: | Background: High-dose biotin therapy is beneficial in progressive multiple sclerosis (MS) and is expected to be adopted by a large number of patients. Biotin therapy leads to analytical interference in many immunoassays that utilize streptavidin-biotin capture techniques, yielding skewed results that can mimic various endocrine disorders. We aimed at exploring this interference, to be able to remove biotin and avoid misleading results. Methods: We measured free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone (TSH), parathyroid homrone (PTH), 25-hydroxyvitamin D (25OHD), follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, C-peptide, cortisol (Roche Diagnostics assays), biotin and its main metabolites (liquid chromatography tandem mass spectrometry) in 23 plasmas from MS patients and healthy volunteers receiving high-dose biotin, and in 39 biotin-unsupplemented patients, before and after a simple procedure (designated N5) designed to remove biotin by means of streptavidin-coated microparticles. We also assayed fT4, TSH and PTH in the 23 high-biotin plasmas using assays not employing streptavidin-biotin binding. Results: The biotin concentration ranged from 31.7 to 1160 µg/L in the 23 high-biotin plasmas samples. After the N5 protocol, the biotin concentration was below the detection limit in all but two samples (8.3 and 27.6 μg/L). Most hormones results were abnormal, but normalized after N5. All results with the alternative methods were normal except two slight PTH elevations. In the 39 biotin-unsupplemented patients, the N5 protocol did not affect the results for any of the hormones, apart from an 8.4% decrease in PTH. Conclusions: We confirm that most streptavidin-biotin hormone immunoassays are affected by high biotin concentrations, leading to a risk of misdiagnosis. Our simple neutralization method efficiently suppresses biotin interference. |
Databáze: | OpenAIRE |
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