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Table. 1.

Table. 1.

Common problems of cross-reaction and specificity in current immunoassays

Analyte Cross-reacting compound Context Reference
Competitive immunoassays
17OH progesterone 17OH pregnenolone sulfate Neonates (especially preterm) Wong, et al. 1992 [182]
Makela and Ellis, 1988 [183]
Cortisol 11 desoxy cortisol 11 Hydroxylase defect
Metyrapone test
Ward, et al. 2017 [26]
Hawley, et al. 2016 [184]
Prednisone, prednisolone and methylprednisolone Corticoid therapy Ward, et al. 2017 [26]
Vogeser, et al. 2017 [185]
Estradiol Estrone sulfate Hormone replacement therapy (oral administration) Thomas, et al. 1993 [186]
Fulvestrant Breast cancer therapy Owen, et al. 2019 [11]
Exemestane metabolites Breast cancer therapy Mandic, et al. 2017 [12]
Progesterone Di-hydroprogesterone Micronized progesterone therapy Nahoul, et al. 1987 [187]
Testosterone Fetal and placental steroids Females, children Taieb, et al. 2003 [188]
Honour, 2010 [17]
Testosterone DHEA-S Females Warner, et al. 2006 [189]
T3 (either total or free) Triiodoacetic acid Piketty, et al. 1996 [190]
DHEAS Pregnenolone sulphate Pregnancy Krasowski, et al. 2014 [191]
Sandwich immunoassays
ACTH 1-39 Fragments, precursor Paraneoplastic tumors Raff and Findling, 1989 [20]
Insulin Pharmacological analogs Inappropriate injection leading to hypoglycemia Parfitt, et al. 2015 [22]
Giurgea, et al. 2005 [24]
Dayaldasani, et al. 2015 [23]
Growth hormone Pegvisomant Acromegaly therapy Paisley, et al. 2007 [18]
Manolopoulou, et al. 2012 [19]
Placental GH Pregnancy Dias, et al. 2013 [192]

Abbreviations: ACTH, adrenocorticotropic hormone; DHEAS, dehydroepiandrosterone sulfate.

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