Free thyroxine concentrations by equilibrium dialysis and chemiluminescent immunoassays in 13 hypothyroid dogs positive for thyroglobulin antibody

J Vet Intern Med. 2015 May-Jun;29(3):877-81. doi: 10.1111/jvim.12573. Epub 2015 Apr 9.

Abstract

Objective: To determine if concentrations of free thyroxine (FT4) measured by semi-automated chemiluminescent immunoassay (CLIA) correspond to FT4 determined by equilibrium dialysis (ED) in hypothyroid dogs positive for thyroglobulin antibody (TGA).

Animals: Thirteen TGA-positive dogs classified as hypothyroid based on subnormal FT4 concentrations by ED.

Methods: Qualitative assessment of canine TGA was performed using an enzyme-linked immunosorbent assay. Serum total thyroxine and total triiodothyronine concentrations were measured by radioimmunoassay. Serum FT4 concentration was determined by ED, and also by semi-automated CLIA for human FT4 (FT4h) and veterinary FT4 (FT4v). Canine thyroid stimulating hormone concentration was measured by semi-automated CLIA.

Results: Each dog's comprehensive thyroid profile supported a diagnosis of hypothyroidism. For detection of hypothyroidism, sensitivities of CLIA for FT4h and FT4v were 62% (95% CI, 32-85%) and 75% (95% CI, 36-96%), respectively, compared to FT4 by ED. Five of 13 (38%) dogs had FT4h and 2 of 8 (25%) dogs had FT4v concentrations by CLIA that were increased or within the reference range. Percentage of false-negative test results for FT4 by CLIA compared to ED was significantly (P < .0001 for FT4h and P < .001for FT4v) higher than the hypothesized false-negative rate of 0%.

Conclusions and clinical importance: Caution should be exercised in screening dogs for hypothyroidism using FT4 measured by CLIA alone. Some (25-38%) TGA-positive hypothyroid dogs had FT4 concentrations determined by CLIA that did not support a diagnosis of hypothyroidism.

Keywords: FT4; TGAA; chemiluminescence; hypothyroidism.

MeSH terms

  • Animals
  • Autoantibodies / immunology*
  • Dog Diseases / blood*
  • Dog Diseases / diagnosis
  • Dog Diseases / immunology
  • Dogs
  • Enzyme-Linked Immunosorbent Assay / veterinary
  • False Positive Reactions
  • Female
  • Hashimoto Disease / blood
  • Hashimoto Disease / diagnosis
  • Hashimoto Disease / immunology
  • Hashimoto Disease / veterinary
  • Hypothyroidism / blood
  • Hypothyroidism / diagnosis
  • Hypothyroidism / immunology
  • Hypothyroidism / veterinary*
  • Luminescent Measurements / methods
  • Luminescent Measurements / veterinary*
  • Male
  • Thyroglobulin / immunology*
  • Thyroiditis, Autoimmune / blood
  • Thyroiditis, Autoimmune / diagnosis
  • Thyroiditis, Autoimmune / immunology
  • Thyroiditis, Autoimmune / veterinary
  • Thyrotropin / blood
  • Thyroxine / blood*
  • Triiodothyronine / blood

Substances

  • Autoantibodies
  • Triiodothyronine
  • Thyrotropin
  • Thyroglobulin
  • Thyroxine

Supplementary concepts

  • Hypothyroidism, Autoimmune