31) Immunoglobulin M- and IgA-specific reagents are not readily available, owing in part to their tendency to interact with heterophile antibodies
, but are under development and likely to become commercially available in the future.
Clinicians should be aware of the characteristics of cardiac troponin assay performance that may be of a general analytical nature, such as interference in the assay from heterophile antibodies
(4), as well as those related to specific features of cardiac troponin biology or the assay used.
are human antibodies with the ability to bind to animal immunoglobulins, thereby possibly interfering with the interaction between animal-derived antibodies and the antigen [hCG in our discussion], which are components of all immunoassays.
The monospot test is a latex assay that causes hemagglutination of horse RBCs in the presence of heterophile antibodies
characteristic of infectious mononucleosis.
determination latex heterophile antibodies
associated with infectious mononucleosis.
appear in 60% of patients with IM within the first and second weeks, and in 80-90% by the first month.
, specific auto-antibodies or rheumatoid factor can interfere in numerous immunoassays, by binding to reagent antibodies or particles, causing falsely increased or decreased results (Fig.
Typically it isn't until the second week of illness that the heterophile antibodies
are made, and they can persist for 6 months or more.
For a final investigation of the possibility of heterophile antibodies
, the HBT treatment and Roche human anti-mouse antibodies procedure were done on a separate patient sample (Table 5).
Two validating cohort studies assessed the accuracy of several commercially available test kits for the detection of heterophile antibodies
(eg, "Mono spot" tests).
Publications regarding the lack of analytical specificity owing to confounders, such as heterophile antibodies
and rheumatoid factor, date back to the early 2000s after the initial introduction of cardiac troponin assays.
In addition, humans naturally produce human anti-human immunoglobulin antibodies or heterophile antibodies
that can cross-react with and bind animal antibodies.