Spuriously High B-Type Natriuretic Peptide Level Caused by Human Antimouse Antibodies
Authors: Xiao-Hong Pan, Song-Zhao Zhang, Hui-Qiang Chen, Mei-Xiang Xiang, Jian-An Wang
Journal: Annals of Internal Medicine (2011)

Letters20 September 2011Spuriously High B-Type Natriuretic Peptide Level Caused by Human Antimouse AntibodiesXiao-Hong Pan, MD, PhD, Song-Zhao Zhang, MD, Hui-Qiang Chen, MD, Mei-Xiang Xiang, MD, PhD, and Jian-An Wang, MD, PhDXiao-Hong Pan, MD, PhDFrom Second Affiliated Hospital, Zhejiang University, 310009 Hangzhou, China.Search for more papers by this author, Song-Zhao Zhang, MDFrom Second Affiliated Hospital, Zhejiang University, 310009 Hangzhou, China.Search for more papers by this author, Hui-Qiang Chen, MDFrom Second Affiliated Hospital, Zhejiang University, 310009 Hangzhou, China.Search for more papers by this author, Mei-Xiang Xiang, MD, PhDFrom Second Affiliated Hospital, Zhejiang University, 310009 Hangzhou, China.Search for more papers by this author, and Jian-An Wang, MD, PhDFrom Second Affiliated Hospital, Zhejiang University, 310009 Hangzhou, China.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-155-6-201109200-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Assays for B-type natriuretic peptide (BNP) are widely used in clinical practice to help confirm or refute the diagnosis of heart failure in patients with dyspnea (1).Objective: To describe how we determined the cause of a falsely high BNP level.Case Report: Clinicians asked us to consult on a 61-year-old man admitted to our hospital with suspected diastolic heart failure and persistently elevated serum BNP levels. The patient had previously been treated for dyspnea and chest discomfort and had a history of hypertension. Our laboratory measured a serum BNP level of 3234 ng/L (normal range, 0 to 80 ...References1. Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, et al. 2009 focused update incorporated into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation. 2009;119:391-479. [PMID: 19324966] MedlineGoogle Scholar2. Apple FS, Wu AH, Jaffe AS, Panteghini M, Christenson RH, Cannon CP, et al. National Academy of Clinical Biochemistry and IFCC Committee for Standardization of Markers of Cardiac Damage Laboratory Medicine Practice Guidelines: Analytical Issues for Biomarkers of Heart Failure. Circulation. 2007;116:95-8. [PMID: 17630411] CrossrefMedlineGoogle Scholar3. Balion CM, Santaguida P, McKelvie R, Hill SA, McQueen MJ, Worster A, et al. Physiological, pathological, pharmacological, biochemical and hematological factors affecting BNP and NT-proBNP. Clin Biochem. 2008;41:231-9. [PMID: 17967418] CrossrefMedlineGoogle Scholar4. Kricka LJ. Human anti-animal antibody interferences in immunological assays. Clin Chem. 1999;45:942-56. [PMID: 10388468] CrossrefMedlineGoogle Scholar5. Bjerner J, Bjerner J, Børmer OP, Nustad K. The war on heterophilic antibody interference. Clin Chem. 2005;51:9-11. [PMID: 15613705] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Second Affiliated Hospital, Zhejiang University, 310009 Hangzhou, China.Acknowledgment: The authors thank Professor Mark Richards, FRSNZ (Christchurch Cardioendocrine Research Group, Department of Medicine, Christchurch School of Medicine and Health Sciences, University of Otago, New Zealand), for his instruction on differential diagnosis.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByChallenges in endocrinology testingChallenges in Endocrinology Testing 20 September 2011Volume 155, Issue 6Page: 407-408KeywordsAntibodiesBrain natriuretic peptidesDiagnostic techniquesDyspneaHeart failureNatriuretic peptidesProhormonesResearch laboratoriesThoraxTriage ePublished: 20 September 2011 Issue Published: 20 September 2011 CopyrightCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...