More on Heterophile and Human Anti-Animal Antibodies

Abstract

In their recent article, Kaplan and Levinson (1) provide an interesting account of the distinction between weak multispecific heterophile antibodies and the highly avid and specific human anti-animal (e.g., mouse) antibodies that may arise from medical treatment with animal proteins. I would like to draw attention to a recent case study I coauthored (2) that was not cited in the article. This highlights the potential confusion of the terms “heterophile antibodies” and “HAMAs”, as discussed by Kaplan and Levinson. However, the case also shows the difficulty in being too pedantic in making the distinction between the two along the lines they suggest. We reported a case of an interference with a thyroid-stimulating hormone assay, and my initial draft referred to this as attributable to heterophile antibodies. However, one of the referees of the article preferred the term HAMAs (human anti-mouse antibodies), so I amended the manuscript accordingly (being unsure myself what to call the interference). The next time I discussed the case with a clinician, I used the term HAMA, but he looked puzzled. “Had the interference changed?” he asked, so I reverted to calling it heterophile. The patient has received no medication with animal products and insists that she has had no contact with mice but had handled pet hamsters. According to the authors’ proposed … [↵][1]aAddress correspondence to this author at: Veterans Administration Medical Center, 800 Zorn Ave., Louisville, KY 40206-1466. Fax 502-894-6265; e-mail levinson{at}louisville.edu [1]: #xref-corresp-1-1