Biotin (vitamin B7) may be taken in high doses by people seeking purported health benefits. Unfortunately high serum levels of biotin can interfere with some laboratory tests.
Mechanism: immunoassays and other laboratory tests may use biotin as a reagent (biotinylated assays)
The interference may cause falsely low (example: troponin) or falsely elevated values (example: free T4).
Features:
(1) The patient has an abnormal laboratory test.
(2) The patient reports high dose biotin supplements.
(3) The serum biotin level is very high.
(4) Repeat testing without biotin supplements show a "true" value.
This may go undetected unless there is a discrepancy between the test result and the clinical picture.
Piketty et al report a procedure (designated N5) that uses strepavidin-coated microparticles to remove the excess biotin from the serum sample.
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