Clinical false positives resulting from recent intravenous immunoglobulin therapy: case report
Abstract 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 met...
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| Format: | Article |
| Language: | English |
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BMC
2021-03-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-021-05986-z |
| _version_ | 1818734847490785280 |
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| author | Janarthanee Suresh Barry D. Kyle |
| author_facet | Janarthanee Suresh Barry D. Kyle |
| author_sort | Janarthanee Suresh |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-18T00:11:52Z |
| format | Article |
| id | doaj.art-57e69e2fa88d4c77ba690b9ed4719acf |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-18T00:11:52Z |
| publishDate | 2021-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-57e69e2fa88d4c77ba690b9ed4719acf2022-12-21T21:27:39ZengBMCBMC Infectious Diseases1471-23342021-03-012111410.1186/s12879-021-05986-zClinical false positives resulting from recent intravenous immunoglobulin therapy: case reportJanarthanee Suresh0Barry D. Kyle1Department of Pathology and Laboratory Medicine, College of Medicine, University of SaskatchewanDepartment of Pathology and Laboratory Medicine, College of Medicine, University of SaskatchewanAbstract 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.https://doi.org/10.1186/s12879-021-05986-zIVIg therapySerologyHepatitisCytomegalovirusThrombocytopenia |
| spellingShingle | Janarthanee Suresh Barry D. Kyle Clinical false positives resulting from recent intravenous immunoglobulin therapy: case report BMC Infectious Diseases IVIg therapy Serology Hepatitis Cytomegalovirus Thrombocytopenia |
| 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 | IVIg therapy Serology Hepatitis Cytomegalovirus Thrombocytopenia |
| url | https://doi.org/10.1186/s12879-021-05986-z |
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