A SPURIOUS MARKEDLY INCREASED SERUM ESTRADIOL LEVEL DUE TO AN IgA LAMBDA

Objective: To alert physicians about the potential for erroneous laboratory determinations of hormone levels and emphasize the need to assess the overall clinical situation as well. Methods: We present a case report of a woman with a dramatically increased serum estradiol (E2) level on radioimmunoassay and review the studies that led to the conclusion that this laboratory finding did not reflect her true estrogen status. Results: In a 41-year-old woman, an unnecessary surgical procedure was performed because of a falsely increased serum E2 level and a unilateral ovarian mass. The markedly increased serum E2 measured by radioimmunoassay was found to be attributable to an IgA lambda that bound to the 125I-labeled tracer of the assay. Conclusion: When repeatedly abnormal hormone levels and the clinical picture seem discrepant, use of a different assay method should be considered.