A Case of Hyperthyroidism Due to Pituitary Resistance to Thyroid Hormone

Endocrine Journal

SHIGEKAZU SASAKI³  HISATO TADA²  YOH HIDAKA²  TAKU KASHIWAI²  SHINICHIRO ANDOH¹  NOBUYUKI AMINO²  HIROTOSHI NAKAMURA¹ 

[1] Department of Internal Medicine, Hamamatsu University School of Medicine;Department of Laboratory Medicine, Osaka University Medical School;Department of Internal Medicine, Kyoto University School of Medicine

关键词: Inappropriate secretion of TSH;    Thyroid hormone resistance;    TSH-secreting pituitary adenoma;    T3 receptor β(TRβ) gene;   

DOI  :  10.1507/endocrj.41.339

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(16)Cited-By(1)A fifteen-year-old male was admitted to our hospital because his thyroid function showed a lack of TSH suppression in the face of elevated thyroid hormone. This patient complained of heat intolerance, palpitation and hand tremor. Peripheral indices of thyroid hormone action indicated a hypermetabolic state. Serum TSH did not respond sufficiently to TRH stimulation, suggesting TSH-secreting pituitary adenoma. However, sellar CT scan and MRI images did not demonstrate any pituitary adenoma. Moreover, the serum TSH α-subunit concentration was not high and serum TSH was partially suppressed by the administration of T3. Furthermore, the results of single stranded conformation polymorphism (SSCP) suggested the existence of mutation(s) in the exon 7 of T3 receptor β (TRβ) gene of this patient. These findings support the diagnosis of pituitary resistance to thyroid hormone.

【 授权许可】

Unknown