Factitiously Elevated Total Triiodothyronine in a Euthyroid Patient with Multiple Myeloma

[helvella]

A rather double-edged issue here.

It would be bad enough suffering multiple myeloma but to have that then result in inappropriate changes to thyroid hormone treatment would be an awful exacerbation.

Hopefully we never see this but I have a horrible feeling all too many medics might get confused in trying to interpret the situation.

Case Rep Endocrinol.2021; 2021: 8479193.

Published online 2021 Aug 30. doi: 10.1155/2021/8479193

PMCID: PMC8421174

PMID: 34497729

Factitiously Elevated Total Triiodothyronine in a Euthyroid Patient with Multiple Myeloma

Kaushik Mandal, Damilola Ashorobi, Alice Lee, Huijuan Liao, Salini C. Kumar, and David S. Rosenthal

Abstract

Sporadic reports of factitious elevations of thyroid hormones related to laboratory interference from autoantibodies and multiple myeloma paraproteins have appeared in the literature. Such clinically confusing laboratory results can lead to erroneous diagnoses and inappropriate treatments. We report an additional case of a patient with multiple myeloma and an IgG paraproteinemia who had such a spurious elevation of total T3 complicating her levothyroxine management of hypothyroidism. In addition, we alert clinicians that differences in performance characteristics between various manufacturers' test platforms may also cause spurious reports.

Full paper freely accessible here:

ncbi.nlm.nih.gov/pmc/articl...

[t3rr]

Quite concerning, I am being regularly tested for increased paraproteins and high kappa count, but have been diagnosed with MGUS, which can lead to myeloma. Also I take lyothironine and levothyroxine, so will be interesting to check my next thyroid blood test results.

[helvella Administrator Thyroid UK in reply to t3rr]

Had wondered whether or not it was worth posting. But if it is of interest to even one person, I am happy that I did so.

Hope you don't need the information. All the best.

[t3rr in reply to helvella]

Thank you