Myeloma immunoglobulin interferes with serum thyroxine analysis by homogeneous enzyme immunoassay

Myeloma immunoglobulin paraproteins interfere with a homogeneous enzyme immunoassay (EMIT) for serum thyroxine. The EMIT assay failed to detect any hormone in three hyperproteinemic sera from multiple myeloma patients, although thyroxine in these sera was accurately measured by our competitive protein-binding radio-assay on small, re-usable Sephadex columns. The interference was due to turbidity of the paraproteins in the EMIT reaction mixture, resulting in an increased absorbance and a marked underestimation of hormone concentration. Thyroxine was detected (82 to 107% recovery) by the EMIT assay in ethanol extracts of myeloma sera. With 82 other sera there was an excellent correlation (r = 0.985, slope = 0.912, Y intercept (EMIT) = 6.8) of the EMIT assay with our competitive radioassay. Thus, although the EMIT thyroxine assay possesses many desirable features and it is an attractive alternative method to competitive radioassays, its susceptibility to interferences by immunoglobulin paraproteins is a troublesome liability.