[Sporadic generalized insensitivity of peripheral tissue receptors to thyroid hormone in a 15 year old boy]

Sporadic generalized form of insensitivity to thyroid hormones of peripheral tissue receptor was proposed as diagnosis in a clinically euthyroid boy 15.5 years old with goiter, having elevated levels of blood serum triiodothyronine (T3) and thyroxine (T4) associated with absence of TSH suppression. Other possible causes of biochemical hyperthyreosis were excluded by differential diagnosis. The results of functional examination of cardiovascular system by the method of Hauffa could be interpreted only as a lack of response of tissue receptors to the administration of triiodothyronine, also when used in pharmacological doses. Lower response of pituitary to the administered triiodothyronine was demonstrated by applying the TRH stimulation test. No antithyroid treatment was applied in accordance with the data from the literature. In long-term observation (above 1.5 year) clinical state of the boy was still good a gradual increase in growth rate and progress in sexual maturation being noted.