ALAN SACERDOTE, M.D.; NARINDER M. KUKAR, M.D.; SHELDON J. BLEICHER, M.D.; ANASTASIO HERRERA, M.D.; FELIPE JUBAY JR., M.D.
To the editor: We read with interest the recently published article "Sustained Remission of Cushing's Disease with Mitotane and Pituitary Irradiation" by Schteingart and colleagues (1). We take exception to one point in their generally excellent report and analysis. They suggest that low thyroxine (T4) levels in mitotane-treated patients could be due to competitive binding of mitotane to thyroxine-binding globulin in the competitive protein binding assay.
We wish to point out, first, that there would be no free mitotane in the patients' serum to interfere with the assay unless blood for T4 levels were drawn almost immediately after a dose.
SACERDOTE A, KUKAR NM, BLEICHER SJ, HERRERA A, JUBAY F. Mitotane and Low Thyroxine Levels. Ann Intern Med. ;94:141. doi: 10.7326/0003-4819-94-1-141
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Published: Ann Intern Med. 1981;94(1):141.
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