Context: Familial dysalbuminemic hyperthyroxinemia, characterized by abnormal circulating albumin with increased T4 affinity, causes artefactual elevation of free T4 concentrations in euthyroid individuals.
Objective: Four unrelated index cases with discordant thyroid function tests in different assay platforms were investigated.
Design And Results: Laboratory biochemical assessment, radiolabeled T4 binding studies, and ALB sequencing were undertaken.