A Case of Hyperthyroidism Due to Pituitary Resistance to Thyroid Hormone

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 hypermetaboli...

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Bibliographic Details
Published in:Endocrine Journal 1994, Vol.41(4), pp.339-343
Main Authors: HIDAKA, YOH, TADA, HISATO, KASHIWAI, TAKU, SASAKI, SHIGEKAZU, ANDOH, SHINICHIRO, NAKAMURA, HIROTOSHI, AMINO, NOBUYUKI
Format: Article
Language:English
Subjects:
Adenoma - complications
Adenoma - drug therapy
Adenoma - metabolism
Adolescent
Drug Resistance
Genes, erbA - genetics
Humans
Hyperthyroidism - drug therapy
Hyperthyroidism - etiology
Hyperthyroidism - metabolism
Inappropriate secretion of TSH
Male
Pituitary Neoplasms - complications
Pituitary Neoplasms - drug therapy
Pituitary Neoplasms - metabolism
Point Mutation
T3 receptor β(TRβ) gene
Thyroid hormone resistance
Thyroid Hormones - therapeutic use
Thyrotropin - blood
TSH-secreting pituitary adenoma
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Summary: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.
ISSN:0918-8959
1348-4540
DOI:10.1507/endocrj.41.339