类风湿因子阳性干扰血TSH测定而误诊为原发性甲减一例分析  

High RF-IgG in the TSH Patient Interfere Clinical and Experimental Analysis

作　　者：闫丹丹[1] 黄婷[1] 时学秀 任彦红[1] 黄爱[2] 栗夏连[1] 

机构地区：[1]郑州大学第一附属医院,河南郑州450000 [2]郑州市儿童医院,河南郑州450000

出　　处：《医学与哲学（B）》2014年第3期77-78,85,共3页Medicine & Philosophy(B)

摘　　要：对1例类风湿因子抗体(RF-IgG)阳性同时伴促甲状腺激素(TSH)升高,按原发性甲减治疗后临床上出现了甲亢症状但血TSH仍很高的患者,进行临床和实验分析,以零TSH血清等倍稀释,观察其变化曲线。用蛋白质G琼脂糖树脂去除血清中IgG,并以缓冲液对未过柱等量血清进行同倍稀释,以排除过柱过程中缓冲液对测定的影响,比较过柱前后TSH水平,发现TSH明显降低,证明RF-IgG可造成TSH假性增高,并证实蛋白质G琼脂糖树脂可去除血清中RFIgG,消除该干扰。A female patient with high serum TSH and extremely high rheumatoid factor （RF）-IgG was treated with thyroid hormone replacement therapy but in vain ,then the reason of high serum TSH in this patient was analyzed .Firstly ,diluted the serum with zero-TSH serum ,the dilution curve was un-linear .Secondly ,used protein G agarose resin was used to remove IgG in the serum ,diluted the serum with buffer in the same ratio ,compared with the serum only diluted with buffer ,the TSH level of the serum treated with protein G decreased .The result was that the high titer of IgG could cause falsely high concentration of TSH ,and the protein G agarose resin could eliminate the interference .

关 键 词：类风湿因子 促甲状腺激素 原发性甲减 

分 类 号：R581.2[医药卫生—内分泌]