Two Cases of Armour Thyroid Interference in Thyroglobulin Monitoring for Thyroid Cancer

Thyroglobulin (Tg) monitoring is the biochemical standard for surveillance of recurrent differentiated thyroid cancer (DTC). Several assays are available to quantify Tg levels: immunometric assay (IMA), radioimmunoassay (RIA), and the newer liquid chromatography tandem mass spectrometry (LC-MS). It...

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Autores principales:	Michelle Ponder, Elizabeth Lamos, Kashif Munir
Formato:	article
Lenguaje:	EN
Publicado:	Hindawi Limited 2021
Materias:	Diseases of the endocrine glands. Clinical endocrinology RC648-665
Acceso en línea:	https://doaj.org/article/442ab023445e4ecdb8f09187de725fa7
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id	oai:doaj.org-article:442ab023445e4ecdb8f09187de725fa7
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spelling	oai:doaj.org-article:442ab023445e4ecdb8f09187de725fa72021-11-29T00:55:31ZTwo Cases of Armour Thyroid Interference in Thyroglobulin Monitoring for Thyroid Cancer2090-651X10.1155/2021/1152572https://doaj.org/article/442ab023445e4ecdb8f09187de725fa72021-01-01T00:00:00Zhttp://dx.doi.org/10.1155/2021/1152572https://doaj.org/toc/2090-651XThyroglobulin (Tg) monitoring is the biochemical standard for surveillance of recurrent differentiated thyroid cancer (DTC). Several assays are available to quantify Tg levels: immunometric assay (IMA), radioimmunoassay (RIA), and the newer liquid chromatography tandem mass spectrometry (LC-MS). It is well known that a number of entities can interfere with the accuracy of testing, and at this point in time, no one assay perfectly balances high sensitivity with low risk of interference. In this case study, we present two cases in which treatment with desiccated thyroid extract (Armour thyroid) led to a sudden elevation in Tg, which resolved when Armour thyroid was discontinued. This elevation occurred when Tg was measured with both IMA and LC-MS, which suggests direct interference from porcine Tg rather than heterophilic or thyroglobulin antibody (TgAb) interference. We suggest that patients with a history of DTC not be treated with desiccated thyroid extracts consistent with guidelines. Furthermore, more advances need to be made in the area of Tg testing to improve specificity and avoid detection of nonhuman Tg and other similar proteins.Michelle PonderElizabeth LamosKashif MunirHindawi LimitedarticleDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENCase Reports in Endocrinology, Vol 2021 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the endocrine glands. Clinical endocrinology RC648-665
spellingShingle	Diseases of the endocrine glands. Clinical endocrinology RC648-665 Michelle Ponder Elizabeth Lamos Kashif Munir Two Cases of Armour Thyroid Interference in Thyroglobulin Monitoring for Thyroid Cancer
description	Thyroglobulin (Tg) monitoring is the biochemical standard for surveillance of recurrent differentiated thyroid cancer (DTC). Several assays are available to quantify Tg levels: immunometric assay (IMA), radioimmunoassay (RIA), and the newer liquid chromatography tandem mass spectrometry (LC-MS). It is well known that a number of entities can interfere with the accuracy of testing, and at this point in time, no one assay perfectly balances high sensitivity with low risk of interference. In this case study, we present two cases in which treatment with desiccated thyroid extract (Armour thyroid) led to a sudden elevation in Tg, which resolved when Armour thyroid was discontinued. This elevation occurred when Tg was measured with both IMA and LC-MS, which suggests direct interference from porcine Tg rather than heterophilic or thyroglobulin antibody (TgAb) interference. We suggest that patients with a history of DTC not be treated with desiccated thyroid extracts consistent with guidelines. Furthermore, more advances need to be made in the area of Tg testing to improve specificity and avoid detection of nonhuman Tg and other similar proteins.
format	article
author	Michelle Ponder Elizabeth Lamos Kashif Munir
author_facet	Michelle Ponder Elizabeth Lamos Kashif Munir
author_sort	Michelle Ponder
title	Two Cases of Armour Thyroid Interference in Thyroglobulin Monitoring for Thyroid Cancer
title_short	Two Cases of Armour Thyroid Interference in Thyroglobulin Monitoring for Thyroid Cancer
title_full	Two Cases of Armour Thyroid Interference in Thyroglobulin Monitoring for Thyroid Cancer
title_fullStr	Two Cases of Armour Thyroid Interference in Thyroglobulin Monitoring for Thyroid Cancer
title_full_unstemmed	Two Cases of Armour Thyroid Interference in Thyroglobulin Monitoring for Thyroid Cancer
title_sort	two cases of armour thyroid interference in thyroglobulin monitoring for thyroid cancer
publisher	Hindawi Limited
publishDate	2021
url	https://doaj.org/article/442ab023445e4ecdb8f09187de725fa7
work_keys_str_mv	AT michelleponder twocasesofarmourthyroidinterferenceinthyroglobulinmonitoringforthyroidcancer AT elizabethlamos twocasesofarmourthyroidinterferenceinthyroglobulinmonitoringforthyroidcancer AT kashifmunir twocasesofarmourthyroidinterferenceinthyroglobulinmonitoringforthyroidcancer
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Two Cases of Armour Thyroid Interference in Thyroglobulin Monitoring for Thyroid Cancer

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