False interpretation of diagnostic serology tests for patients treated with pooled human immunoglobulin G infusions: a trap for the unwary

Therapeutic immunoglobulin G (IgG) products are produced from numerous plasma donations, and are infused in many medical conditions. The serological testing of patients who have received IgG infusions may well produce falsely positive and misleading results from this infused IgG, rather than endogen...

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Veröffentlicht in:Clinical medicine (London, England) Jg. 15; H. 2; S. 125 - 129
Hauptverfasser: Bright, Philip D, Smith, Lisa, Usher, Jane, Donati, Matthew, Johnston, Sarah L, Gompels, Mark M, Unsworth, D Joe
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England Elsevier Ltd 01.04.2015
Royal College of Physicians
Schlagworte:
Adult
Antibodies, Bacterial - blood
antibody
Autoantibodies - blood
Clinical Practice
false positive
False Positive Reactions
Female
Hepatitis B Antibodies - blood
Humans
immunoglobulin
Immunoglobulin G - administration & dosage
Immunoglobulin G - adverse effects
Immunoglobulin G - blood
Serologic Tests - standards
Serology
Syphilis Serodiagnosis
Serology
antibody
immunoglobulin
false positive
ISSN:1470-2118, 1473-4893
Online-Zugang:Volltext
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Zusammenfassung:Therapeutic immunoglobulin G (IgG) products are produced from numerous plasma donations, and are infused in many medical conditions. The serological testing of patients who have received IgG infusions may well produce falsely positive and misleading results from this infused IgG, rather than endogenously produced IgG. We present two example cases of clinical situations where this could cause concern. We tested multiple IgG products with a range of serological tests performed in infective or autoimmune conditions, including hepatitis B, syphilis, human immunodeficiency virus, human T-lymphotropic virus, anti-neutrophil cytoplasmic antibody (ANCA), anti-nuclear antibody (ANA), anti-cardiolipin antibodies and anti-double stranded DNA (dsDNA) antibody. We found positivity within these products for hepatitis B surface and core antibody, syphilis, ANCA, ANA, anti-cardiolipin IgG and dsDNA antibody, which may result from specific or non-specific reactivity. The serological testing of patients who have received IgG treatment detects the administered IgG in addition to IgG produced by the patient.
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ISSN:1470-2118
1473-4893
DOI:10.7861/clinmedicine.15-2-125