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Pituitary thyroid resistance syndrome
S Norlela1, K Nor Azmi, B A K Khalid
1Endocrine Unit, Department of Medicine, Faculty of Medicine Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, 56000, Cheras, Kuala Lumpur.
The Medical Journal of Malaysia
|March 7, 2006
Summary
Thyroid hormone resistance (RTH) is a rare disorder causing high thyroid hormone levels with normal TSH. A rare pituitary resistance case highlights this condition's complexity.
Area of Science:
- Endocrinology
- Genetics
- Molecular Biology
Background:
- Thyroid hormone resistance (RTH) is a rare autosomal dominant disorder.
- Characterized by elevated thyroid hormones and measurable TSH.
- Most RTH cases (85%) involve mutations in the thyroid hormone receptor beta (TRβ).
Observation:
- A 35-year-old man presented with hypermetabolic symptoms.
- He had elevated thyroid hormones and nonsuppressed thyrotropin (TSH).
- This presentation suggested resistance at the pituitary level.
Findings:
- Treatment with anti-thyroid drugs normalized thyroid hormone levels.
- TSH levels increased after treatment.
- This response indicated pituitary-level thyroid hormone resistance.
Implications:
- This case highlights the rare pituitary thyroid resistance syndrome.
- It expands understanding of RTH beyond TRβ mutations.
- Further research into pituitary resistance mechanisms is warranted.