RT Journal Article
SR Electronic
T1 False interpretation of diagnostic serology tests for patients treated with pooled human immunoglobulin G infusions: a trap for the unwary
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 125
OP 129
DO 10.7861/clinmedicine.15-2-125
VO 15
IS 2
A1 Philip D Bright
A1 Lisa Smith
A1 Jane Usher
A1 Matthew Donati
A1 Sarah L Johnston
A1 Mark M Gompels
A1 D Joe Unsworth
YR 2015
UL http://www.rcpjournals.org/content/15/2/125.abstract
AB 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.