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Partial peripheral resistance to thyroid hormone

M M Kaplan, S L Swartz, P R Larsen

    The American Journal of Medicine
    |May 1, 1981
    PubMed
    Summary
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    This study investigated thyroid hormone resistance in a patient with variable responses to L-triiodothyronine (T3) therapy. Despite high T3 levels, she showed hypothyroid symptoms and suppressed TSH, indicating peripheral resistance.

    Area of Science:

    • Endocrinology
    • Molecular Biology
    • Metabolic Research

    Background:

    • Thyroid hormone resistance is a rare condition characterized by decreased tissue sensitivity to thyroid hormones.
    • Understanding the variable manifestations and molecular basis is crucial for diagnosis and management.

    Observation:

    • A partially thyroidectomized woman was studied with daily L-triiodothyronine (T3) doses ranging from 50 to 500 micrograms.
    • She exhibited hypothyroid symptoms and reduced oxygen consumption at lower T3 doses, despite markedly elevated serum T3 concentrations.
    • Normal absorption, protein binding, and metabolic clearance of T3 were observed.

    Findings:

    • Thyroid-stimulating hormone (TSH) secretion was suppressed by all T3 doses, and the prolactin response to thyrotropin-releasing hormone (TRH) was blunted at higher doses.

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  • Urinary creatine and hydroxyproline increased with T3 dosage, indicating normal protein catabolism, while other biochemical markers remained largely unchanged.
  • Clinical parameters such as pulse rate, blood pressure, and exercise tolerance showed minimal changes.

    • Implications:

    • The study highlights the variable clinical and biochemical manifestations of peripheral thyroid hormone resistance.
    • Further research is needed to elucidate the molecular basis of this condition in the studied patient.
    • Comparing findings with 17 other patients underscores the heterogeneity of thyroid hormone resistance syndromes.