This article reviews the most common errors while interpreting endocrine tests' including the hook effect and falsely normal values of prolactin (PRL) mainly in macroprolactinomas, macroprolactinemia and falsely elevated PRL, macro thyrotropinoma and falsely elevated thyroid-stimulating hormone (TSH) levels, heterophile antibodies leading to a false hormone elevation, biotin interference with hormonal assays and cross-reactivity of steroidal hormones with immunoassays cases and a brief overview of the other conditions.Īdditionally, because of the large number of endocrinology laboratory tests available, we outline a brief description of the laboratory tests that are most frequently used to diagnose the disorders in each of the disease groups, with an emphasis on when to request such tests, how to interpret them, the most common errors that occur during interpretation, typical clinical scenarios, and recommendations to avoid these errors for each axis. These errors lead to misinterpretations during the initial clinical impression and therefore, the therapeutic approach. Recognizing these situations is essential for the clinician to make an adequate interpretation of these tests as well as an accurate diagnosis that guarantees the best outcomes for the patient.ĭespite the development of laboratory techniques in the last few years, problems and errors occurring while interpreting endocrine tests persist. Some of these tests can be affected by situations that affect the proper interpretation, leading to incorrect diagnoses and unnecessary treatment, such as the interference of biotin with thyroid function test, falsely elevated prolactin values in presence of macroprolactinemia or falsely normal due to the “hook effect” in macroprolactinomas. 5Endocrinology Section, Internal Medicine Department, Faculty of Medicine, University of Antioquia, Medellin, ColombiaĮndocrine tests are the cornerstone of diagnosing multiple diseases that primary care physicians are frequently faced with.4Faculty of Medicine, University of Cartagena, Cartagena, Colombia.3Faculty of Medicine, University of Antioquia, Medellin, Colombia.2Internal Medicine Service, Institución Prestadora de Servicios (IPS) Universitaria - Clínica León XIII, Medellin, Colombia.1Internal Medicine Department, Faculty of Medicine, University of Antioquia, Medellin, Colombia.
Alvarez-Payares 1,2*, Jesus David Bello-Simanca 3, Edwin De Jesus De La Peña-Arrieta 3, Jose Emilio Agamez-Gomez 3, Jhon Edwar Garcia-Rueda 3, Amilkar Rodriguez-Arrieta 4 and Luis Antonio Rodriguez-Arrieta 5
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