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Clinical false positives resulting from recent intravenous immunoglobulin therapy: case report

BACKGROUND: Many clinicians are aware that certain therapies administered to their patients can have downstream consequences in the form of clinical laboratory test interferences. This is particularly true of laboratory tests that depend on, or directly involve the use of, antibody-based methodology...

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Autores principales: Suresh, Janarthanee, Kyle, Barry D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7981890/
https://www.ncbi.nlm.nih.gov/pubmed/33743628
http://dx.doi.org/10.1186/s12879-021-05986-z
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author Suresh, Janarthanee
Kyle, Barry D.
author_facet Suresh, Janarthanee
Kyle, Barry D.
author_sort Suresh, Janarthanee
collection PubMed
description BACKGROUND: Many clinicians are aware that certain therapies administered to their patients can have downstream consequences in the form of clinical laboratory test interferences. This is particularly true of laboratory tests that depend on, or directly involve the use of, antibody-based methodology. Intravenously-administered immunoglobulin therapy is one such treatment that can in theory directly impact the results of particular tests in the area of viral serology. This study can help serve as a reference for clinicians researching the impact of intravenously-administered immunoglobulin therapy in the context of positive results that do not reflect the clinical background of the patient. CASE PRESENTATION: We describe a case whereby an intravenously-administered immunoglobulin therapy led to a series of clinical false positives in viral serology, inconsistent with the known patient history as well as recent laboratory results. The patient presented to hospital with petechiae-type bleeding rashes and was investigated for thrombocytopenia after initial blood investigations indicated very low platelets. Subsequent testing of the potential causes for low-platelet involved several viral serology investigations, including hepatitis, cytomegalovirus and human immunodeficiency virus. Initial testing indicated patient exhibited negative status for all viral antibodies and antigens (except immunity for hepatitis B surface antigen antibody). As part of the thrombocytopenia treatment, intravenously-administered immunoglobulin therapy was administered, and subsequent viral serology was ordered. These investigations indicated a positive status for several hepatitis antibodies as well as cytomegalovirus. CONCLUSIONS: This case study illustrates the potential for improper diagnosis of previous or ongoing infection status in patients administered IVIg therapy. Caution should be exercised particularly when interpreting results involving cytomegalovirus and hepatitis.
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spelling pubmed-79818902021-03-22 Clinical false positives resulting from recent intravenous immunoglobulin therapy: case report Suresh, Janarthanee Kyle, Barry D. BMC Infect Dis Case Report BACKGROUND: Many clinicians are aware that certain therapies administered to their patients can have downstream consequences in the form of clinical laboratory test interferences. This is particularly true of laboratory tests that depend on, or directly involve the use of, antibody-based methodology. Intravenously-administered immunoglobulin therapy is one such treatment that can in theory directly impact the results of particular tests in the area of viral serology. This study can help serve as a reference for clinicians researching the impact of intravenously-administered immunoglobulin therapy in the context of positive results that do not reflect the clinical background of the patient. CASE PRESENTATION: We describe a case whereby an intravenously-administered immunoglobulin therapy led to a series of clinical false positives in viral serology, inconsistent with the known patient history as well as recent laboratory results. The patient presented to hospital with petechiae-type bleeding rashes and was investigated for thrombocytopenia after initial blood investigations indicated very low platelets. Subsequent testing of the potential causes for low-platelet involved several viral serology investigations, including hepatitis, cytomegalovirus and human immunodeficiency virus. Initial testing indicated patient exhibited negative status for all viral antibodies and antigens (except immunity for hepatitis B surface antigen antibody). As part of the thrombocytopenia treatment, intravenously-administered immunoglobulin therapy was administered, and subsequent viral serology was ordered. These investigations indicated a positive status for several hepatitis antibodies as well as cytomegalovirus. CONCLUSIONS: This case study illustrates the potential for improper diagnosis of previous or ongoing infection status in patients administered IVIg therapy. Caution should be exercised particularly when interpreting results involving cytomegalovirus and hepatitis. BioMed Central 2021-03-21 /pmc/articles/PMC7981890/ /pubmed/33743628 http://dx.doi.org/10.1186/s12879-021-05986-z Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Suresh, Janarthanee
Kyle, Barry D.
Clinical false positives resulting from recent intravenous immunoglobulin therapy: case report
title Clinical false positives resulting from recent intravenous immunoglobulin therapy: case report
title_full Clinical false positives resulting from recent intravenous immunoglobulin therapy: case report
title_fullStr Clinical false positives resulting from recent intravenous immunoglobulin therapy: case report
title_full_unstemmed Clinical false positives resulting from recent intravenous immunoglobulin therapy: case report
title_short Clinical false positives resulting from recent intravenous immunoglobulin therapy: case report
title_sort clinical false positives resulting from recent intravenous immunoglobulin therapy: case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7981890/
https://www.ncbi.nlm.nih.gov/pubmed/33743628
http://dx.doi.org/10.1186/s12879-021-05986-z
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