REVUE ALGERIENNE D’ALLERGOLOGIE
Volume 10, Numéro 2, Pages 59-65
2026-01-05
Hook Effect In Indirect Immunofluorescence Assay: Always On Alert
Authors : Bouacha El-bahdja . Zemouli Yamina . Benachour Nassima .
Abstract
Introduction: Indirect immunofluorescence assay (IIFA) represents the most effective method for screening autoantibodies, it has been known to hold the standard over other techniques for its low report of false negatives, although observed rarely in IIFA a marked prozone effect occurred leading to erroneous results. by reporting these observations, we aim to put this phenomenon in the spotlight mainly in AMA2 and anti-LC1 antibodies detection. Methods: This retrospective study includes four patient's laboratory findings that indicate the prevalence of false-negative anti-mitochondrial (AMA) and anti-liver cytosol (anti-LC1) antibodies resulting from excess antibodies in serum. Results: Absence of immunofluorescence at certain dilutions, its appearance at others highly suggest the presence of prozone phenomenon in these cases Conclusion: All laboratories providing IIF assays should be alert to the continuing possibility of hook effect, excellent communication between laboratory and clinical staff is key to minimize the risk due to analytical errors.
Keywords
Prozone effect ; Indirect immune-fluorescence assay ; anti-mitochondrial antibodies ; anti-liver cytosol antibodies
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