Delayed False Elevation of Circulating Tacrolimus Concentrations after Cord Blood Transplantation in a Patient with Myelodysplastic Syndrome

Kiyohito Hayashi; Taizo Tasaka; Tadashi Hirose; Satoko Furukawa; Katsunori Kohguchi; Yoshiko Matsuhashi; Hideho Wada; Kaoru Tohyama; Takashi Sugihara

doi:10.2169/internalmedicine.53.2170

CASE REPORTS

Delayed False Elevation of Circulating Tacrolimus Concentrations after Cord Blood Transplantation in a Patient with Myelodysplastic Syndrome

Kiyohito Hayashi, Taizo Tasaka, Tadashi Hirose, Satoko Furukawa, Katsunori Kohguchi, Yoshiko Matsuhashi, Hideho Wada, Kaoru Tohyama, Takashi Sugihara

Author information

Kiyohito Hayashi
Department of Hematology, Kawasaki Medical School, Japan
Taizo Tasaka
Department of Hematology, Kawasaki Medical School, Japan
Tadashi Hirose
Department of Hematology, Kawasaki Medical School, Japan
Satoko Furukawa
Department of Laboratory Medicine, Kawasaki Medical School, Japan
Katsunori Kohguchi
Department of Laboratory Medicine, Kawasaki Medical School, Japan
Yoshiko Matsuhashi
Department of Hematology, Kawasaki Medical School, Japan
Hideho Wada
Department of Hematology, Kawasaki Medical School, Japan
Kaoru Tohyama
Department of Laboratory Medicine, Kawasaki Medical School, Japan
Takashi Sugihara
Department of Hematology, Kawasaki Medical School, Japan

Keywords: antibody-conjugated magnetic immunoassay, cord blood transplantation, tacrolimus, autoimmune diseases

JOURNAL OPEN ACCESS

2014 Volume 53 Issue 22 Pages 2635-2638

DOI https://doi.org/10.2169/internalmedicine.53.2170

Details

Abstract

We herein describe the case of a 60-year-old man with a history of Behçet's disease and myelodysplastic syndrome who received cord blood transplantation (CBT). The patient was given anti-thymocyte globulin conditioning and tacrolimus to prevent graft-versus-host disease. Two months after CBT, his blood Tac concentration measured by an antibody-conjugated magnetic immunoassay (ACMIA) was found to have increased >4-fold, even after the Tac treatment was stopped. This false response was caused by the interference of endogenous heterophilic antibodies with ACMIA. Therefore, physicians must be aware of possible false ACMIA results for patients with a history of autoimmune disease and/or treated by xenogeneic antibody therapy.

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