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Resistance to thyroid hormone
1Department of Medicine, University of Chicago, Illinois.
Abstract:
Resistance to thyroid hormone encompasses a clinically heterogeneous group of conditions characterized by reduced responses of target tissues to a supply of thyroid hormone that under normal circumstances would be excessive. The syndrome of resistance to thyroid hormone is first suspected when serum thyroid hormone levels are found to be elevated in the presence of nonsuppressed serum thyrotropin (TSH). Clinical confirmation of the diagnosis requires the demonstration of the failure of full replacement doses of thyroid hormone to produce the expected suppressive effect on the secretion of TSH and a failure to induce appropriate responses in peripheral tissues.
Insights
Resistance to thyroid hormone (RTH) involves reduced tissue response to thyroid hormone. Diagnosis requires elevated thyroid hormone with nonsuppressed TSH, and lack of response to hormone replacement therapy.
Area of Science:
- Endocrinology
- Molecular Genetics
- Internal Medicine
Background:
- Resistance to thyroid hormone (RTH) is a rare genetic disorder.
- Characterized by impaired thyroid hormone action in target tissues.
- Leads to elevated thyroid hormone levels with normal or elevated TSH.
Purpose of the Study:
- To define the diagnostic criteria for RTH.
- To outline the clinical and biochemical features of RTH.
- To differentiate RTH from other thyroid disorders.
Main Methods:
- Biochemical assays for thyroid hormones and TSH.
- Assessment of TSH suppression by thyroid hormone administration.
- Clinical evaluation of peripheral tissue responses.
Main Results:
- Elevated free thyroid hormones (T4 and T3) with unsuppressed TSH are key indicators.
- Lack of TSH suppression after thyroid hormone administration confirms the diagnosis.
- Variable clinical manifestations across different tissues.
Conclusions:
- RTH diagnosis relies on specific biochemical and physiological criteria.
- Confirms the heterogeneous nature of RTH.
- Highlights the importance of functional testing for accurate diagnosis.