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Related Experiment Videos

Pituitary resistance to thyroid hormones.

P Beck-Peccoz1, F Forloni, D Cortelazzi

  • 1Institute of Endocrine Sciences, University of Milan, Ospedale Maggiore IRCCS, Italy.

Hormone Research
|January 1, 1992
PubMed
Summary

Pituitary thyroid hormone resistance (PRTH) presents with high thyroid hormones and unsuppressed TSH. Overlapping symptoms with generalized resistance raise questions about PRTH as a distinct condition.

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Area of Science:

  • Endocrinology
  • Genetics
  • Molecular Biology

Background:

  • Pituitary thyroid hormone resistance (PRTH) is characterized by thyroid hormone insensitivity solely in pituitary thyrotropin (TSH)-secreting cells.
  • Clinical presentation often includes hyperthyroid symptoms like goiter and tachycardia, alongside elevated free thyroid hormones and unsuppressed TSH.
  • PRTH diagnosis relies on these hormonal findings and hyperthyroid peripheral markers.

Purpose of the Study:

  • To investigate the clinical and genetic characteristics of patients suspected of having PRTH.
  • To evaluate the distinction between PRTH and generalized thyroid hormone resistance (GRTH).
  • To determine if PRTH represents a unique clinical entity or part of a broader spectrum of thyroid hormone resistance.

Main Methods:

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  • Review of clinical data, hormonal assays (free thyroid hormones, TSH), and peripheral thyroid hormone action parameters in patients with suspected PRTH.
  • Genetic analysis to identify mutations in the gene encoding the T3 nuclear receptor.
  • Comparison of PRTH patient characteristics with those of GRTH patients.

    • Main Results:

    • Patients with suspected PRTH exhibit clinical and hormonal profiles that significantly overlap with GRTH.
    • Many PRTH patients display normal peripheral thyroid hormone action markers, despite hyperthyroid symptoms.
    • Mutations in the T3 nuclear receptor gene are found in a significant proportion of PRTH patients, similar to GRTH.

    Conclusions:

    • The findings challenge the classification of PRTH as a separate entity from GRTH.
    • Evidence suggests that PRTH and GRTH may represent variable expressions of a single spectrum of thyroid hormone resistance.
    • Further research is needed to fully elucidate the molecular mechanisms and clinical spectrum of thyroid hormone resistance.