Interference of the antihormone RU486 in the determination of testosterone and estradiol by enzyme-immunoassay

Tejada, Francisco; Cremades, Adolfo Díaz-Bautista; Monserrat, F.; Peñafiel, Rafael

doi:10.1016/s0009-8981(98)00077-1

Cited by 14 publications

(9 citation statements)

References 18 publications

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“…Commercial kits, however, now rarely describe or are willing to disclose the chemical nature of the hapten or ligand or other reagents used in an assay. Many drugs and their metabolites cross‐react, particularly in steroid immunoassays 35–39 . Drugs such as heparin can affect thyroid function tests 40 .…”

Section: Pre‐analytical Issuesmentioning

confidence: 99%

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Unusual results from immunoassays and the role of the clinical endocrinologist

Jones

Honour

2006

Clinical Endocrinology

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Section: Pre‐analytical Issuesmentioning

confidence: 99%

“…Many drugs and their metabolites cross-react, particularly in steroid immunoassays. [35][36][37][38][39] Drugs such as heparin can affect thyroid function tests. 40 Use in the patient of biotin is rare but has been shown to influence enzyme immunoassay of TSH and free T4.…”

Section: Drugsmentioning

confidence: 99%

Unusual results from immunoassays and the role of the clinical endocrinologist

Jones

Honour

2006

Clinical Endocrinology

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“…Examples include cross-reactivity of DHEA sulfate with testosterone immunoassays [10,11], mifepristone with estradiol and testosterone enzyme immunoassays [12], and methylprednisolone with cortisol immunoassays [13]. …”

Section: Introductionmentioning

confidence: 99%

Cross-reactivity of steroid hormone immunoassays: clinical significance and two-dimensional molecular similarity prediction

et al. 2014

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BackgroundImmunoassays are widely used in clinical laboratories for measurement of plasma/serum concentrations of steroid hormones such as cortisol and testosterone. Immunoassays can be performed on a variety of standard clinical chemistry analyzers, thus allowing even small clinical laboratories to do analysis on-site. One limitation of steroid hormone immunoassays is interference caused by compounds with structural similarity to the target steroid of the assay. Interfering molecules include structurally related endogenous compounds and their metabolites as well as drugs such as anabolic steroids and synthetic glucocorticoids.MethodsCross-reactivity of a structurally diverse set of compounds were determined for the Roche Diagnostics Elecsys assays for cortisol, dehydroepiandrosterone (DHEA) sulfate, estradiol, progesterone, and testosterone. These data were compared and contrasted to package insert data and published cross-reactivity studies for other marketed steroid hormone immunoassays. Cross-reactivity was computationally predicted using the technique of two-dimensional molecular similarity.ResultsThe Roche Elecsys Cortisol and Testosterone II assays showed a wider range of cross-reactivity than the DHEA sulfate, Estradiol II, and Progesterone II assays. 6-Methylprednisolone and prednisolone showed high cross-reactivity for the cortisol assay, with high likelihood of clinically significant effect for patients administered these drugs. In addition, 21-deoxycortisol likely produces clinically relevant cross-reactivity for cortisol in patients with 21-hydroxylase deficiency, while 11-deoxycortisol may produce clinically relevant cross-reactivity in 11β-hydroxylase deficiency or following metyrapone challenge. Several anabolic steroids may produce clinically significant false positives on the testosterone assay, although interpretation is limited by sparse pharmacokinetic data for some of these drugs. Norethindrone therapy may impact immunoassay measurement of testosterone in women. Using two-dimensional similarity calculations, all compounds with high cross-reactivity also showed a high degree of similarity to the target molecule of the immunoassay.ConclusionsCompounds producing cross-reactivity in steroid hormone immunoassays generally have a high degree of structural similarity to the target hormone. Clinically significant interactions can occur with structurally similar drugs (e.g., prednisolone and cortisol immunoassays; methyltestosterone and testosterone immunoassays) or with endogenous compounds such as 21-deoxycortisol that can accumulate to very high concentrations in certain disease conditions. Simple similarity calculations can help triage compounds for future testing of assay cross-reactivity.

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“…Studies relating speci¢cally to interference in testosterone assay in women are sparse. Possible causes of the interference cited are danazol (a gonadotrophin inhibitor with androgenic and antioestrogenic properties), 6--8 the abortifecent mifepristone (RU486) 9 and SHBG. 10,11 In a previous study, we developed an extraction method for female testosterone for use on the Abbott Architect analyser.…”

Section: Introductionmentioning

confidence: 99%