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Thyroid. 2019 Dec 10. doi: 10.1089/thy.2019.0058. [Epub ahead of print]

Free thyroxine concentrations in sera of individuals with Familial Dysalbuminemic Hyperthyroxinemia: a comparison of three methods of measurement.

Author information

1
The University of Chicago, Medicine , 5841 South Maryland Avenue, MC 3090, Chicago, Illinois, United States, 60637-1470; srefetof@uchicago.edu.
2
The University of Chicago, Department of Medicine, Chicago, Illinois, United States; nscherbe@medicine.bsd.uchicago.edu.
3
Quest Diagnostics Nichols Institute, 355082, San Juan Capistrano, California, United States; Chao.X.Yuan@questdiagnostics.com.
4
Quest Diagnostics Nichols Institute, 355082, San Juan Capistrano, California, United States; William.W.Wu@QuestDiagnostics.com.
5
Quest Diagnostics Nichols Institute, 355082, San Juan Capistrano, California, United States; Zeng.R.Wu@QuestDiagnostics.com.
6
Quest Diagnostics Nichols Institute, Endocrine Division, San Juan Capistrano, California, United States; michael.j.mcphaul@questdiagnostics.com.

Abstract

Euthyroid individuals with Familial Dysalbuminemic Hyperthyroxinemia (FDH) have often falsely elevated serum free T4 (FT4) concentrations determined by different automated immunoassays. We measured serum FT4 using direct dialysis coupled with tandem mass spectrometry (FT4 DDMS) in individuals with the common albumin gene mutation (ALB R218H) from 14 FDH families and compared to results obtained by direct immunometric assay (FT4 DIMM) and free T4 index (FT4I). While all 14 individuals with FDH had elevated total serum T4, the FT4 measured by DIMM was elevated in 12, by FT4I in 5, and by DDMS in 1. The latter method greatly reduced the discordance of FT4 results relative to TSH in FDH.

PMID:
31822224
DOI:
10.1089/thy.2019.0058

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