Keywords
Heterophile
Indirect Immunofluorescence
How to Cite
Abstract
Introduction: Heterophilic antibodies (HA) are directed against antigens from another species. These antibodies can mimic specific autoantibodies, leading to diagnostic errors in the study by indirect immunofluorescence (IIF). Objectives: To highlight the importance of recognizing the characteristic images of HA and to analyze their incidence in samples from patients attending hospital laboratories. Materials and methods: An observational, longitudinal, prospective and analytical study was carried out. The presence of HA in serum was evaluated in two cohorts of patients, who had been admitted consecutively for the study of specific antibodies in two hospitals in the City of Buenos Aires (n=661). The IIF technique was used on rat liver, kidney and stomach sections. Results: The incidence of specific antibodies was higher than that of HA (19.2 % vs 10.1 %), APCA (6.8), ASMA, (6.2) AMA (5.7 %) and LKM (0.4 %). No concomitance between HA and specific antibodies was found in the two cohorts studied. Among the characteristic patterns of HA, the coloration of the brush border was 7.1 %, parietal cells 5.6 % and smooth muscle 3.2 %, and Kupffer cells 0.4 %. Conclusions: Although the frequency of specific antibodies was higher than that of HA, the latter were present in 10.1 % of the patients and with up to three concomitant characteristic patterns. Thus, it is of utmost importance that the observer is trained to identify HA, since they could mimic specific antibodiesand this could lead to misinterpretation of the results.
References
Taber’s cyclopedic medical dictionary. Philadelphia, PA: FA Davis, 1989:826. https://fadavispt.mhmedical.com/content.aspx?sectionid=174264026&bookid=2132#174264112
Dawkins RL, Stephen C, Pummer B, Romano G, Frueger B, Peter N et al. Heterophile Antibodies. In JB Peter and Y Shoenfeld Editors. Autoantibodies, 1th ed. Netherlands. Elsevier 1996. P351-356.
Ireton HJ, Muller HK, McGiven AR. Human antibody against rat gastric parietal cells and kidney brush border. Clin Exp Immunol. 1971;8(5):783-9.
Strickland RG, Hooper B. The parietal cell heteroantibody in humansera: prevalence in a normal population and relationship to parietal cell autoantibody. Pathology. 1972;4(4):259-63.
Hawkins BR, McDonald BL, Dawkins RL. Characterization of immunofluorescent heterophile antibodies which may be confused with autoantibodies. J Clin Pathol. 1977;30(4):299-307.
McDonald BL, Hawkins BR, Dawkins RL, Davey MG. Characterization of human heterophile antibodies apparently induced by alloimmunization. Vox Sang. 1977;33(3):143-9.
Kaplan SS Levinson. When is a heterophile antibody not a heterophile antibody? When is it an antibody against a specific immunogen. Clin Chem. 1999;45(5):616-18
Van Der Geld H. Anti-Heart Antibodies in The Postpericardiotomy and The Postmyocardial-Infarction Syndromes. Lancet. 1964;2(7360):617-21.
Ireton HJ, Muller HK, McGiven AR. Human antibody against rat gastric parietal cells and kidney brush border. Clin Exp Immunol. 1971;8(5):783-9.
Strickland RG, Hooper B. The parietal cell heteroantibody in human sera: prevalence in a normal population and relationship to parietal cell autoantibody. Pathology. 1972;4(4):259-63.
Scott-Morgan L y Lloyd RS. Problems associated with the presence of immunofluorescent heterophile antibody in sera submitted for autoantibody screening. J. Immunol. Met. 1984;66:69-74.
Rizzetto M, Doniach D. Types of ‘reticulin’ antibodies detected in human sera by immunofluorescence. J Clin Pathol. 1973;26(11):841-51.
Doniach D, Roitt IM, Walker JG, Sherlock S. Tissue antibodies in primary biliary cirrhosis, active chronic (lupoid) hepatitis, cryptogenic cirrhosis and other liver diseases and their clinical implications. Clin Exp Immunol. 1966;1(3):237-62.
Johnson GD, Holborow EJ, Glynn LE. Antibody to smooth muscle in patients with liver disease. Lancet. 1965;2(7418):878-9.
Muller HK, McGiven AR, Nairn RC. Immunofluorescent staining of rat gastric parietal cells by human antibody unrelated to pernicious anaemia. J Clin Pathol. 1971;24(1):13-4.
Strickla RG, Hoope B. The parietal cell heteroantibody in human sera: Prevalence in a normal population and relationship to parietal cell autoantibody. Patholoy. 1972;4:259-63.
Hawkins BR, Saueracker GC, Dawkins RL, Davey MG, O´Connor KJ. Population Study of Heterophile Antibodies. Vox Sang 1980; 39: 339-342