In March, Alexander M. Markov, MD; Sina Jasim, MD, MPH; and Jennifer Powers Carson, PhD had their article titled “A Puzzling Case of Elevated Parathyroid Hormone,” published by The Journal of Applied Laboratory Medicine.
The authors reviewed a case of a 45-year-old woman who presented to surgical oncology for hyperparathyroidism management. With a history of thyroid nodules, the patient had obtained an ultrasound that displayed two solid lesions that were inferior to the right lobe, which raised the concern for parathyroid adenomas or reactive lymph nodes.
“After efforts to rule out secondary and normocalcemic hyperparathyroidism, a diagnosis of hyperparathyroidism could not be made. Although, examination of results from 2021 taken alone would not have led to a conclusion of heterophilic antibody interference, all data taken together does suggest this as the strongest possibility.”
Drs. Markov, Jasim and Powers Carson express that the case shows the importance of considering assay interference when interpreting lab results for cases in which the findings differ from those in clinical and imaging. Since normocalcemic hyperparathyoidism and heterophilic antibody interferences both elevate parathyroid hormone levels, being able to distinguish between the two is essential. They further state that “while many methods are available for confirming heterophilic antibody interferences, standard guidelines for interpretation are still lacking and are sorely needed for accurate patient diagnosis and management.”
Alexander M Markov, Sina Jasim, Jennifer Powers Carson, A Puzzling Case of Elevated Parathyroid Hormone, The Journal of Applied Laboratory Medicine, Volume 9, Issue 2, March 2024, Pages 399–403, https://doi.org/10.1093/jalm/jfad078