Is It T3 Thyrotoxicosis? A Case of Falsely Elevated Tri-Iodothyronine (T3) Levels Leading to a Diagnosis of Multiple Myeloma

We are presenting a case of falsely elevated T3 levels in a patient due to interference from monoclonal immunoglobulins. A 56-year-old, clinically euthyroid man referred to the endocrinology clinic of the Aga Khan university, Karachi Pakistan, for possible T3 thyrotoxicosis after thyroid function te...

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Main Authors: Nanik Ram, Saira Furqan, Sibtain Ahmed
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Case Reports in Endocrinology
Online Access:http://dx.doi.org/10.1155/2019/5028534
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author Nanik Ram
Saira Furqan
Sibtain Ahmed
author_facet Nanik Ram
Saira Furqan
Sibtain Ahmed
author_sort Nanik Ram
collection DOAJ
description We are presenting a case of falsely elevated T3 levels in a patient due to interference from monoclonal immunoglobulins. A 56-year-old, clinically euthyroid man referred to the endocrinology clinic of the Aga Khan university, Karachi Pakistan, for possible T3 thyrotoxicosis after thyroid function tests revealed total T3 >12.32 nmol/L (reference range 0.6–2.79), normal TSH, and total T4 level. There was a mismatch in clinical and laboratory parameters and preliminary laboratory results were suggestive of thyroid binding globulin abnormalities. Further evaluation in this context unmasked multiple myeloma. The presence of monoclonal immunoglobulins can lead to assay interference and spurious results. To the best of our knowledge, this is the second case defining the cause of falsely elevated T3 levels, due to assay interferences with binding of T3 only to monoclonal immunoglobulins.
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series Case Reports in Endocrinology
spelling doaj-art-c03a1b11520e4fada19d030f79ed7ba42025-02-03T06:07:09ZengWileyCase Reports in Endocrinology2090-65012090-651X2019-01-01201910.1155/2019/50285345028534Is It T3 Thyrotoxicosis? A Case of Falsely Elevated Tri-Iodothyronine (T3) Levels Leading to a Diagnosis of Multiple MyelomaNanik Ram0Saira Furqan1Sibtain Ahmed2Department of Medicine, Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, PakistanDepartment of Medicine, Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, PakistanDepartment of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, PakistanWe are presenting a case of falsely elevated T3 levels in a patient due to interference from monoclonal immunoglobulins. A 56-year-old, clinically euthyroid man referred to the endocrinology clinic of the Aga Khan university, Karachi Pakistan, for possible T3 thyrotoxicosis after thyroid function tests revealed total T3 >12.32 nmol/L (reference range 0.6–2.79), normal TSH, and total T4 level. There was a mismatch in clinical and laboratory parameters and preliminary laboratory results were suggestive of thyroid binding globulin abnormalities. Further evaluation in this context unmasked multiple myeloma. The presence of monoclonal immunoglobulins can lead to assay interference and spurious results. To the best of our knowledge, this is the second case defining the cause of falsely elevated T3 levels, due to assay interferences with binding of T3 only to monoclonal immunoglobulins.http://dx.doi.org/10.1155/2019/5028534
spellingShingle Nanik Ram
Saira Furqan
Sibtain Ahmed
Is It T3 Thyrotoxicosis? A Case of Falsely Elevated Tri-Iodothyronine (T3) Levels Leading to a Diagnosis of Multiple Myeloma
Case Reports in Endocrinology
title Is It T3 Thyrotoxicosis? A Case of Falsely Elevated Tri-Iodothyronine (T3) Levels Leading to a Diagnosis of Multiple Myeloma
title_full Is It T3 Thyrotoxicosis? A Case of Falsely Elevated Tri-Iodothyronine (T3) Levels Leading to a Diagnosis of Multiple Myeloma
title_fullStr Is It T3 Thyrotoxicosis? A Case of Falsely Elevated Tri-Iodothyronine (T3) Levels Leading to a Diagnosis of Multiple Myeloma
title_full_unstemmed Is It T3 Thyrotoxicosis? A Case of Falsely Elevated Tri-Iodothyronine (T3) Levels Leading to a Diagnosis of Multiple Myeloma
title_short Is It T3 Thyrotoxicosis? A Case of Falsely Elevated Tri-Iodothyronine (T3) Levels Leading to a Diagnosis of Multiple Myeloma
title_sort is it t3 thyrotoxicosis a case of falsely elevated tri iodothyronine t3 levels leading to a diagnosis of multiple myeloma
url http://dx.doi.org/10.1155/2019/5028534
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