Pan Qingrong, Zhang Yeqing, Zhang Wenkai, Hu Yanjin, Chen Zhe, Liu Aijun, Wang Guang
Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China.
Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China; Department of Internal Medicine, The First Hospital of Fangshan District, Beijing, China.
Endocr Pract. 2021 Mar;27(3):236-240. doi: 10.1016/j.eprac.2020.09.004. Epub 2020 Dec 13.
To evaluate the prevalence of euthyroid hypertriiodothyroninemia and/or hyperthyroxinemia and its clinical characteristics in multiple myeloma (MM) patients.
Previously untreated, newly diagnosed patients with MM were enrolled at the Beijing Chao-yang Hospital between January 2016 and December 2019. Thyroid function and clinical characteristics were analyzed.
A total of 105 patients were enrolled in this study. Thirteen (12.38%) patients exhibited euthyroid hypertriiodothyroninemia with strikingly elevated total triiodothyronine (TT3) levels (>8 ng/mL). Among these 13 patients, 12 patients were immunoglobulin (Ig) G type (92.31%), and 1 patient was light-chain κ type (7.69%). Compared with other patients with MM, patients with hypertriiodothyroninemia were more likely to be IgG type and had higher serum globulin and lower albumin levels and more advanced International Staging System stage (all P < .05). Among the 13 euthyroid hypertriiodothyroninemia patients, 8 patients have been followed up and checked for thyroid function. The TT3 levels in all 8 patients were normalized to the reference range after antimyeloma chemotherapy.
About 12% of patients with MM had euthyroid hypertriiodothyroninemia. Their strikingly elevated TT3 was normalized after chemotherapy. Clinicians should be aware of the possibility of high TT3 levels in euthyroid patients with MM and the potential risk of MM in patients with strikingly elevated TT3.
评估甲状腺功能正常的高总三碘甲状腺原氨酸血症和/或高甲状腺素血症在多发性骨髓瘤(MM)患者中的患病率及其临床特征。
2016年1月至2019年12月期间,在北京朝阳医院纳入既往未治疗、新诊断的MM患者。分析甲状腺功能和临床特征。
本研究共纳入105例患者。13例(12.38%)患者表现为甲状腺功能正常的高总三碘甲状腺原氨酸血症,总三碘甲状腺原氨酸(TT3)水平显著升高(>8 ng/mL)。在这13例患者中,12例为免疫球蛋白(Ig)G型(92.31%),1例为轻链κ型(7.69%)。与其他MM患者相比,高总三碘甲状腺原氨酸血症患者更可能为IgG型,血清球蛋白水平较高,白蛋白水平较低,国际分期系统分期更晚(均P<0.05)。在13例甲状腺功能正常的高总三碘甲状腺原氨酸血症患者中,8例患者接受了随访并检查了甲状腺功能。所有8例患者在接受抗骨髓瘤化疗后,TT3水平恢复至参考范围。
约12%的MM患者存在甲状腺功能正常的高总三碘甲状腺原氨酸血症。化疗后其显著升高的TT3恢复正常。临床医生应意识到MM患者甲状腺功能正常但TT3水平升高的可能性,以及TT3显著升高患者发生MM的潜在风险。