Article Text

Download PDFPDF
Prevalence of elevated serum concentrations of biotin in patients from South East England, Korea, Singapore and Thailand and risk of immunoassay interference
  1. Sally Brady1,
  2. Katharine Bates2,
  3. Susan Oddy3,
  4. You La Jeon4,
  5. Tosapol Pichayayothin5,
  6. Ruby Tetteh3,
  7. Kieran Voong6,
  8. Dominic J Harrington6,7
  1. 1 Department of Clinical Biochemistry, HCA Laboratories, London, UK
  2. 2 Department of Blood Sciences, King’s College Hospital, SYNLAB UK & Ireland, London, UK
  3. 3 Department of Blood Sciences, Addenbrooke's Hospital, Cambridge, UK
  4. 4 GC Labs, Yongin-si, Korea (the Republic of)
  5. 5 Bangkok R.I.A. Laboratory, Bangkok, Thailand
  6. 6 Nutristasis Unit, St. Thomas' Hospital, SYNLAB UK & Ireland, London, UK
  7. 7 Faculty of Life Sciences and Medicine, King's College London, London, UK
  1. Correspondence to Dr Sally Brady, Department of Clinical Biochemistry, HCA Laboratories, London, WC1E 6JA, UK; sally.brady{at}


Biotin interference in immunoassays using biotin-streptavidin binding technology is well recognised by clinical laboratories, though the prevalence of elevated biotin in patient populations is largely unknown. We determined serum biotin concentrations in 4385 patient samples received sequentially by 6 laboratories for routine immunoassay analysis in England, and Korea, Singapore and Thailand (3 countries within the Asia Pacific region, APAC). Samples were initially analysed using a research use-only immunoassay, with those identified as having potentially elevated biotin concentrations referred for definitive analysis by LC-MS/MS. The prevalence of elevated serum biotin was 0.4% and 0.6% for England and APAC, respectively (range 10.0–129.0 µg/L). Our data adds to a report from a different region of England and is the first for APAC. Laboratories and clinicians benefit from an awareness of the prevalence of elevated serum biotin, which coupled with an understanding of the threshold at which interference occurs, reduces clinical impact of analytical error.

  • Chemistry, Clinical
  • Diagnostic Techniques and Procedures
  • Hormones
  • Medical Laboratory Science

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Handling editor Patrick J Twomey.

  • Twitter @DrDJHarrington

  • Contributors All authors contributed to this work, meeting ICMJE Recommendations. No other individual has been excluded from the author list.

  • Funding This work was funded by Abbott Diagnostics.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.