False interpretation of diagnostic serology tests for patients treated with pooled human immunoglobulin G infusions: A trap for the unwary

Philip D. Bright*, Lisa Smith, Jane Usher, Matthew Donati, Sarah L. Johnston, Mark M. Gompels, D. Joe Unsworth

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

25 Citations (Scopus)

Abstract

Therapeutic immunoglobulin G (IgG) products are produced from numerous plasma donations, and are infused in many medical conditions. The serological testing of patients who have received IgG infusions may well produce falsely positive and misleading results from this infused IgG, rather than endogenously produced IgG. We present two example cases of clinical situations where this could cause concern. We tested multiple IgG products with a range of serological tests performed in infective or autoimmune conditions, including hepatitis B, syphilis, human immunodeficiency virus, human T-lymphotropic virus, anti-neutrophil cytoplasmic antibody (ANCA), anti-nuclear antibody (ANA), anti-cardiolipin antibodies and anti-double stranded DNA (dsDNA) antibody. We found positivity within these products for hepatitis B surface and core antibody, syphilis, ANCA, ANA, anticardiolipin IgG and dsDNA antibody, which may result from specific or non-specific reactivity. The serological testing of patients who have received IgG treatment detects the administered IgG in addition to IgG produced by the patient.

Original languageEnglish
Pages (from-to)125-129
Number of pages5
JournalClinical Medicine, Journal of the Royal College of Physicians of London
Volume15
Issue number2
DOIs
Publication statusPublished - 1 Apr 2015

Bibliographical note

Publisher Copyright:
© Royal College of Physicians 2015. All rights reserved.

Keywords

  • Antibody
  • False positive
  • Immunoglobulin
  • Serology

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