Spurious prostate-specific antigen (PSA) recurrence after radical prostatectomy: Interference by human antimouse heterophile antibodies
Article first published online: 8 DEC 2006
International Journal of Urology
Volume 14, Issue 3, pages 251–253, March 2007
How to Cite
Park, S., Wians Jr, F. H. and Cadeddu, J. A. (2007), Spurious prostate-specific antigen (PSA) recurrence after radical prostatectomy: Interference by human antimouse heterophile antibodies. International Journal of Urology, 14: 251–253. doi: 10.1111/j.1442-2042.2006.01648.x
- Issue published online: 10 APR 2007
- Article first published online: 8 DEC 2006
- Received 10 May 2006; accepted 19 July 2006.
- biochemical recurrence;
- heterophile antibody;
- prostate specific antigen
Abstract: Human antimouse heterophile antibodies (HAMA) are naturally occurring antibodies that can interfere with modern serum assays. We report a case of HAMA interference with a commonly used prostate-specific antigen (PSA) assay, leading to false elevation (2.17–2.46 ng/mL) after radical prostatectomy. Pre-operative PSA was 4.4 ng/mL, and final pathology was Gleason 3 + 3, pT2cNXMX. This markedly elevated postoperative PSA led to unnecessary imaging for metastasis and psychological distress to the patient. Direct measurement of HAMA in the patient’s serum yielded a value of 440 ng/mL (<74 ng/mL). An alternate PSA assay using goat detection antibody eliminated interference, with all values 0.05 ng/mL. When a patient’s PSA is inconsistent with the clinical scenario, one should consider immunological interference by HAMA in PSA assays.