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Case Report

J Lab Med Qual Assur 2015; 37(3): 148-152

Published online September 30, 2015

https://doi.org/10.15263/jlmqa.2015.37.3.148

Copyright © Korean Association of External Quality Assessment Service.

False Increase in Whole Blood Tacrolimus Levels due to Interference in an Antibody-Conjugated Magnetic Immunoassay Method

Kyong-Ho Cha, Jeong- Joong Lee, Han-Na Kim, Hyojin Chae, and Yonggoo Kim

Department of Laboratory Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea

Correspondence to:Yonggoo Kim
Department of Laboratory Medicine, Seoul St. Mary’s Hospital, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea
Tel: +82-2-2258-1642
Fax: +82-2-2258-1719
E-mail: yonggoo@catholic.ac.kr

Received: March 25, 2015; Revised: June 14, 2015; Accepted: June 15, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Tacrolimus is an immunosuppressive agent used to prevent post-transplantation rejection. Tacrolimus has a narrow therapeutic window and therefore, its whole blood concentration is measured for therapeutic drug monitoring. In this report, we present two cases of falsely elevated tacrolimus concentrations identified in recipients of solid organ transplants due to analytical interferences in the antibody-conjugated magnetic immunoassay (ACMIA) method used. Tacrolimus concentrations measured using ACMIA were 4- to 8-fold higher than the values obtained using liquid-chromatography-tandem mass spectrometry (LCMS/ MS) or chemiluminescent micro-particle immunoassay. The cause of this interference remains unknown, but the identification of a possible false elevation of tacrolimus is of paramount importance in clinical practice. Pre-treatment of samples by ethanol extraction or using alternative methods of tacrolimus measurement such as LC-MS/MS are necessary to obtain reliable results in the event of an analytical interference.
(J Lab Med Qual Assur 2015;37:148-152)

Keywords: Tacrolimus, Immunoassay, Interference, Antibody-conjugated magnetic immunoassay

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