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Sarkar R. A simple method to overcome paraproteinemic interferences in chemistry and immunoassays. Lab Med 2024:lmae042. [PMID: 38860476 DOI: 10.1093/labmed/lmae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Interferences on chemistry and immunoassay results due to paraproteinemia may lead to erroneous diagnoses and treatment. Such interferences are difficult to recognize and even more difficult to deal with. This report describes 1 such case where multiple measurands were affected and how the interferant was overcome. CASE REPORT Paraproteins present in an immunoglobulin (Ig)G-lambda multiple myeloma specimen interfered with results of total bilirubin, direct bilirubin, inorganic phosphate, iron, ferritin, and total thyroxine measured on 3 platforms: AU5800, Alinity ci, and cobas pure. Repeat testing upon dilution with normal saline or deproteinization by polyethylene glycol precipitation gave unsatisfactory results on some or all the affected measurands. Repeat testing after dilution of the interferant serum with a healthy serum corrected the anomalous results for all the affected measurands. CONCLUSION Dilution of paraproteinemic serum with a healthy serum of known concentrations appears to be the most suitable method to negate the effects of paraproteinemic interferences.
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Koch CA, Vita R, Benvenga S. The various faces of hyperthyroidism. J Clin Transl Endocrinol 2020; 20:100229. [PMID: 32632358 PMCID: PMC7274125 DOI: 10.1016/j.jcte.2020.100229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Christian A. Koch
- Fox Chase Cancer Center, Philadelphia, PA, USA
- The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Roberto Vita
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Salvatore Benvenga
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
- Master Program on Childhood, Adolescent and Women's Endocrine Health, University of Messina, Messina, Italy
- Interdepartmental Program on Molecular and Clinical Endocrinology, and Women’s Endocrine Health, University Hospital, A.O.U. Policlinico G. Martino, Messina, Italy
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Mancuso S, Carlisi M, Napolitano M, Siragusa S. Lymphomas and thyroid: Bridging the gap. Hematol Oncol 2018; 36:519-524. [PMID: 29484690 DOI: 10.1002/hon.2504] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 12/27/2017] [Accepted: 01/24/2018] [Indexed: 01/08/2023]
Abstract
The thyroid gland is often involved in the development of neoplastic diseases, including lymphoproliferative disorders. The aim of this paper is to provide a comprehensive overview of the multiple interactions between lymphoma and thyroid. Through an extensive research among the literature, the relationship between lymphomas and thyroid can be established at various levels, and the possible interconnections are here summarized in 5 points: (1) the greater risk of lymphoma development in some thyroid diseases; (2) the primary thyroid lymphoma, with focus on issues related to the diagnosis, differential diagnosis, and treatment; (3) the incidence of thyroid involvement in primitive nodal lymphomas or in extranodal lymphomas of the other sites; (4) thyroid changes after treatment of lymphoma, in relation to the effects of radiation therapy and immuno-chemotherapy; (5) the incidental findings of thyroid changes, on imaging, in patients with lymphoma, without a direct involvement of the gland in malignant disease. In conclusion, issues that until now have been dealt with separately will therefore be analyzed in a unique paper, allowing a global view of the topic and emphasizing the need of a multidisciplinary approach. Future learning areas in this topic mainly relate to rapidly increasing the knowledge of imaging studies together with expanding the armamentarium of novel biological and targeting agents in lymphoma patients.
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Affiliation(s)
- Salvatrice Mancuso
- Department of Oncology, Haematology Unit, University of Palermo School of Medicine, Palermo, Italy
| | - Melania Carlisi
- Department of Oncology, Haematology Unit, University of Palermo School of Medicine, Palermo, Italy
| | - Mariasanta Napolitano
- Department of Oncology, Haematology Unit, University of Palermo School of Medicine, Palermo, Italy
| | - Sergio Siragusa
- Department of Oncology, Haematology Unit, University of Palermo School of Medicine, Palermo, Italy
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Benvenga S, Guarneri F. AL amyloidosis, hypothyroidism and reduced tissue availability of thyroid hormones by thyroid hormone-binding immunoglobulin: a new possible perspective. J Intern Med 2018; 283:106-107. [PMID: 28805259 DOI: 10.1111/joim.12660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- S Benvenga
- Department of Clinical and Experimental Medicine - Endocrinology, University of Messina, Messina, Italy.,Master Program on Childhood, Adolescent and Women's Endocrine Health, University of Messina, Messina, Italy.,Interdepartmental Program on Molecular & Clinical Endocrinology and Women's Endocrine Health, AOU Policlinico G. Martino, Messina, Italy
| | - F Guarneri
- Department of Clinical and Experimental Medicine - Dermatology, University of Messina, Messina, Italy
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Mondello P, Mian M, Pitini V, Cuzzocrea S, Sindoni A, Galletti M, Mandolfino M, Santoro D, Mondello S, Aloisi C, Altavilla G, Benvenga S. Thyroid hormone autoantibodies: are they a better marker to detect early thyroid damage in patients with hematologic cancers receiving tyrosine kinase inhibitor or immunoregulatory drug treatments? Curr Oncol 2016; 23:e165-70. [PMID: 27330353 PMCID: PMC4900836 DOI: 10.3747/co.23.3026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Unlike cytotoxic agents, novel antineoplastic drugs can variably affect thyroid function and so impair patient outcomes. However, the widely used standard thyroid tests have demonstrated low sensitivity for detecting early thyroid damage that leads to dysfunction of the gland. To find a more reliable thyroid marker, we assessed the presence of antibodies binding thyroid hormones (thAbs) in a cancer population undergoing potentially thyrotoxic treatment. METHODS From April 2010 to September 2013, 82 patients with hematologic malignancies treated with tyrosine kinase inhibitors or immunoregulatory drugs were recruited. Healthy volunteers (n = 104) served as control subjects. Thyroid function, autoimmunity tests, thAbs, and thyroid sonography were assessed once during treatment. RESULTS Overall, thAb positivity was recorded in 13% of the entire cohort. In most cases, the thAbs were of a single type, with a predominance of T3 immunoglobulin G. More specifically, thAbs were detected in 11 cancer patients; and abnormal levels of thyroid-stimulating hormone, thyroglobulin antibody, and thyroperoxidase antibody were detected in 6 (p = 0.05), 0 (p = 0.0006), and 2 cancer patients (p = 0.001) respectively. Ultrasonographic alterations of the thyroid were observed in 12 cancer patients. In contrast, of the 104 healthy control subjects, only 1 was positive for thAbs (1%). CONCLUSIONS We have demonstrated for the first time that thAbs are a reliable marker of early thyroid dysfunction when compared with the widely used standard thyroid tests. A confirmatory prospective trial aiming at evaluating thAbs at various time points during treatment could clarify the incidence and timing of antibody appearance.
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Affiliation(s)
- P. Mondello
- Department of Human Pathology, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
- Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, U.S.A
| | - M. Mian
- Department of Hematology and CBMT, Hospital of Bolzano, Bolzano, Italy
| | - V. Pitini
- Department of Human Pathology, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - S. Cuzzocrea
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - A. Sindoni
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - M. Galletti
- Section of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - M. Mandolfino
- Section of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - D. Santoro
- Department of Internal Medicine, University of Messina, Messina, Italy
| | - S. Mondello
- Department of Neurosciences, University of Messina, Messina, Italy
| | - C. Aloisi
- Department of Internal Medicine, University of Messina, Messina, Italy
| | - G. Altavilla
- Department of Human Pathology, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - S. Benvenga
- Section of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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