Acquired refractoriness to thyroid hormone action in treated toxic nodular goiter

A case of apparent target organ refractoriness to thyroid hormones has been observed during the recovery phase of toxic nodular goiter after 131I therapy. The serum PBI was normal before the onset, but elevated serum PBI and T4 concentrations were observed during the toxic phase, and after recovery, with elevated T3 as well. The case differed in important respects from the congenital, hereditary disorder known as the Refetoff syndrome.