A Case of Intravenous IVIg Interfering with Serological Test Results of HBV.

IF 0.7 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Clinical laboratory Pub Date : 2024-07-01 DOI:10.7754/Clin.Lab.2024.240140
Dan Zhang, Debao Yu
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Abstract

Background: Since Imbach [1] first reported the use of high-dose intravenous immunoglobulin (IVIg) in the treatment of idiopathic thrombocytopenic purpura (ITP) in children, indications for IVIg therapy have been increaseing. At present, IVIg infusion has become an important means of clinical treatment. The phenomenon of anti-HBs and anti-HBc elevation caused by IVIg infusion in patients has been reported in journals, but similar reports in journals related to laboratory diagnosis are rare.

Methods: We reported a case of a patient with immune thrombocytopenia (ITP) which interfered with hepatitis B virus (HBV) serological detection after receiving intravenous IVIg. We used chemiluminescence immunoassay to detect serological markers of HBV. IU/mL was used to represent the detection data of HBsAg and HBsAb and cutoff value was used to represent the detection HBeAg, HBeAb, and HbcAb.

Results: The serological markers of HBV were all negative before IVIg infusion. One week after IVIG infusion, the item was tested again, and the results of HBsAb, HBeAb, and HBcAb were positive. As the time increased after infusion, HBsAb, HBeAb, and HBcAb in the patient gradually decreased.

Conclusions: After IVIg infusion, the sudden positive change of HBsAb, HBeAb, and HbcAb in the patient's body was not caused by HBV infection, but caused by the infusion of foreign antibody. This case study shows that physicians should be particularly careful when interpreting results in patients treated with intravenous IVIg involving viral hepatitis B.

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一例静脉注射 IVIg 干扰 HBV 血清学检测结果的病例。
背景:自英巴赫(Imbach)[1]首次报道使用大剂量静脉注射免疫球蛋白(IVIg)治疗儿童特发性血小板减少性紫癜(ITP)以来,IVIg 治疗的适应症不断增加。目前,IVIg 输注已成为临床治疗的重要手段。关于患者因输注IVIg而导致抗-HBs和抗-HBc升高的现象在期刊上已有报道,但在与实验室诊断相关的期刊上却鲜有类似报道:我们报告了一例免疫性血小板减少症(ITP)患者在接受静脉注射 IVIg 后影响乙型肝炎病毒(HBV)血清检测的病例。我们采用化学发光免疫测定法检测 HBV 血清学标记物。用 IU/mL 表示 HBsAg 和 HBsAb 的检测数据,用截断值表示 HBeAg、HBeAb 和 HbcAb 的检测数据:结果:输注 IVIG 前,HBV 血清学指标均为阴性。输注 IVIG 一周后再次检测,HBsAb、HBeAb 和 HBcAb 结果均为阳性。随着输注后时间的延长,患者体内的 HBsAb、HBeAb 和 HBcAb 逐渐减少:结论:输注 IVIg 后,患者体内的 HBsAb、HBeAb 和 HbcAb 突然呈阳性变化,并非 HBV 感染所致,而是输注了外来抗体。本病例研究表明,医生在解释接受静脉注射 IVIg 治疗的乙型病毒性肝炎患者的结果时应特别谨慎。
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来源期刊
Clinical laboratory
Clinical laboratory 医学-医学实验技术
CiteScore
1.50
自引率
0.00%
发文量
494
审稿时长
3 months
期刊介绍: Clinical Laboratory is an international fully peer-reviewed journal covering all aspects of laboratory medicine and transfusion medicine. In addition to transfusion medicine topics Clinical Laboratory represents submissions concerning tissue transplantation and hematopoietic, cellular and gene therapies. The journal publishes original articles, review articles, posters, short reports, case studies and letters to the editor dealing with 1) the scientific background, implementation and diagnostic significance of laboratory methods employed in hospitals, blood banks and physicians'' offices and with 2) scientific, administrative and clinical aspects of transfusion medicine and 3) in addition to transfusion medicine topics Clinical Laboratory represents submissions concerning tissue transplantation and hematopoietic, cellular and gene therapies.
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