Heterophilic antibodies produce spuriously elevated concentrations of the MB isoenzyme of creatine kinase in a selected patient population

Abstract

Dual-site murine antibody-based immunoassays are commonly used in clinical laboratories to quantitate the MB isoenzyme of creatine kinase (CK-MB). Because the serum level of CK-MB is a relatively specific and sensitive indicator of myocardial ischemic damage, accurate quantitation is essential for a correct diagnosis. Heterophile antibodies (eg, human anti-murine antibodies) can interfere with these assays, however, and produce erroneous results. A subpopulation of 19 surgical patients with colorectal carcinoma who had received injections of an 125I-labeled murine monoclonal antibody directed against a tumor-associated glycoprotein was studied. Serum specimens from eight patients (42%) showed a marked increase in the level of CK-MB and normal total CK concentrations. The increased concentrations of CK-MB, which were attributed to interference by human antimurine antibodies, were substantially reduced in these specimens after a heterophile blocking reagent was added. However, this reagent did not significantly alter the serum level of CK-MB in patients who had clinical evidence of acute myocardial ischemia.