Thyrotoxicosis factitia masquerading as recurrent Graves’ disease: endogenous antibody immunoassay interference, a pitfall for the unwary

Ann Clin Biochem 2008;45:325-327
© 2008 Association for Clinical Biochemistry


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Case Reports

V R Jahagirdar1,2,
P Strouhal3,
G Holder4,
R Gama2,5 and
B M Singh1

1 Department of Diabetes and Endocrinology;
2 Department of Clinical Chemistry;
3 Department of Radiology, New Cross Hospital, Wolverhampton WV10 0QP, UK;
4 Department of Clinical Biochemistry, University Hospital Birmingham, Birmingham B29 6JB, UK;
5 Research Institute, Wolverhampton University, West Midlands WY1 1SB, UK

Corresponding author: Prof R Gama, Department of Clinical Chemistry, New Cross Hospital, Wolverhampton WV10 0QP, UK. Email: rousseau.gama{at}

Antibody interference in immunoassays is an underestimated problem,which has the potential to cause patient harm and waste health-careresources. We report a case where thyroglobulin antibodies generateda false-positive thyroglobulin result delaying the diagnosisof thyrotoxicosis factitia masquerading as recurrent Graves’disease. A high index of clinical suspicion and good laboratory-cliniciancommunication underpins effective clinical and laboratory strategiesto detect potentially erroneous laboratory results due to endogenousantibody interference in immunoassays.

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