{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:19:54Z","timestamp":1787840394621,"version":"build-2784847793"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Immunoassays used to measure thyroid function tests (TFTs) are prone to interference due to several factors that could potentially affect clinical decisions. With increased awareness and frequency of testing TFT, even 1% prevalence of assay interferences would possibly increase the occurrence of deranged TFT significantly. In this study, we report six cases of thyroid hormone assay interference in acute scrub typhus infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A prospective observational study was conducted in patients admitted with acute scrub typhus infection. TFT was done for some indication that showed discordance with clinical suspicion. Initial assay was performed by electrochemiluminescence immunoassay (ECLIA) using a Roche Cobas e411 analyzer, which was verified by Chemiluminescent Microparticle Immuno Assay (CMIA) with an ARCHITECT i1000SR analyzer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Initial TFT done by ECLIA showed elevated FT4 and FT3(FT4&gt;&gt; FT3) with a normal or low-normal TSH in all cases. Samples were re-analyzed in the CMIA platform within 24 hours, which showed normal TFT, raising the suspicion of assay interference. TFT performed by ECLIA 6 weeks after recovery was normal in all patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Assay interference with TFT should always be considered when there is a discrepancy between clinical suspicion and biochemical values. It is prudent to confirm abnormal values on another platform to avoid misdiagnosis and unwarranted therapeutic decisions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijem.ijem_28_25","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T08:00:30Z","timestamp":1761552030000},"page":"578-581","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Variation in Thyroid Function Tests in Acute Scrub Typhus Infection"],"prefix":"10.4103","volume":"29","author":[{"given":"Sai N.","family":"Gogineni","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism, SRMC, Porur, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adlyne R.","family":"Asirvatham","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, SRMC, Porur, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasireddy N.","family":"Tara","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, SRMC, Porur, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veeraraghava K.","family":"Ramadesikan","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry, Sundaram Medical Foundation, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asha","family":"Ranjan","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, SRMC, Porur, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shriraam","family":"Mahadevan","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, SRMC, Porur, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,10,25]]},"reference":[{"key":"R1-20251029","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1210\/er.2018-00119","article-title":"Interferences with thyroid function immunoassays: Clinical implications and detection algorithm","volume":"39","author":"Favresse","year":"2018","journal-title":"Endocr Rev"},{"key":"R2-20251029","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.1210\/jcem-27-12-1667","article-title":"Early alterations in thyroid hormone physiology during acute infection in man","volume":"27","author":"Shambaugh","year":"1967","journal-title":"J Clin Endocrinol Metab"},{"key":"R3-20251029","doi-asserted-by":"crossref","first-page":"e0009619","DOI":"10.1371\/journal.pntd.0009619","article-title":"The burden of scrub typhus in India: A systematic review","volume":"15","author":"Devasagayam","year":"2021","journal-title":"PLoS Negl Trop Dis"},{"key":"R4-20251029","first-page":"e30092","article-title":"Recent threat of scrub typhus in India: A narrative review","volume":"14","author":"Kore","year":"2022","journal-title":"Cureus"},{"key":"R5-20251029","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.ijid.2018.03.018","article-title":"Kinetics of IgM and IgG antibodies after scrub typhus infection and the clinical implications","volume":"71","author":"Varghese","year":"2018","journal-title":"Int J Infect Dis"},{"key":"R6-20251029","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.cca.2020.11.018","article-title":"Heterophilic antibody interference with TSH measurement on different immunoassay platforms","volume":"512","author":"Cheng","year":"2021","journal-title":"Clin Chim Acta"},{"key":"R7-20251029","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.cca.2019.07.010","article-title":"Heterophile antibody interference affecting multiple Roche immunoassays: A case study","volume":"497","author":"Serei","year":"2019","journal-title":"Clin Chim Acta"},{"key":"R8-20251029","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1258\/acb.2010.010160","article-title":"Interference by antiruthenium antibodies in the Roche thyroid-stimulating hormone assay","volume":"48","author":"Buijs","year":"2011","journal-title":"Ann Clin Biochem"},{"key":"R9-20251029","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.it.2004.02.004","article-title":"Polyreactivity of antibody molecules","volume":"25","author":"Notkins","year":"2004","journal-title":"Trends Immunol"},{"key":"R10-20251029","doi-asserted-by":"crossref","first-page":"50","DOI":"10.4103\/ijem.ijem_349_22","article-title":"Study of non-thyroidal illness syndrome and its recovery in critically ill patients at a tertiary care centre in south India","volume":"27","author":"Praveen","year":"2023","journal-title":"Indian J Endocrinol Metab"},{"key":"R11-20251029","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1677\/JOE-09-0412","article-title":"Mechanisms behind the non-thyroidal illness syndrome: An update","volume":"205","author":"Warner","year":"2010","journal-title":"J Endocrinol"},{"key":"R12-20251029","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/j.beem.2013.06.007","article-title":"Principles and pitfalls of free hormone measurements","volume":"27","author":"Faix","year":"2013","journal-title":"Best Pract Res Clin Endocrinol Metab"}],"container-title":["Indian Journal of Endocrinology and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijem.ijem_28_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:21:58Z","timestamp":1787836918000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijem.ijem_28_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":12,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ijem.ijem_28_25","relation":{},"ISSN":["2230-8210","2230-9500"],"issn-type":[{"value":"2230-8210","type":"print"},{"value":"2230-9500","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"2025-01-17","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-10","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}