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[Pituitary resistance to thyroid hormone]
1First Department of Internal Medicine, Nagasaki University School of Medicine.
Nihon Rinsho. Japanese Journal of Clinical Medicine
|October 1, 1993
Summary
Thyroid hormone resistance syndromes involve target tissue unresponsiveness to thyroid hormones. Recent discoveries suggest selective pituitary resistance to thyroid hormone (PRTH) is part of generalized resistance, not a distinct condition.
Area of Science:
- Endocrinology
- Molecular Genetics
Context:
- Thyroid hormone resistance syndromes (THRS) present with target tissue unresponsiveness.
- Distinct subtypes include generalized, selective pituitary, and peripheral resistance.
- Patients exhibit elevated thyroid hormones (T4, T3) with normal/high TSH.
Purpose:
- To investigate the classification of selective pituitary resistance to thyroid hormone (PRTH).
- To determine if PRTH is a distinct entity or part of a broader spectrum.
Summary:
- PRTH is characterized by normal peripheral tissue response but abnormal pituitary response to thyroid hormones, leading to hyperthyroidism.
- Cloning of the thyroid hormone receptor (T3 receptor) enabled mutation detection.
- Mutations in the T3 receptor gene provide evidence that PRTH is a manifestation of generalized T3 resistance.
Impact:
- Reclassifies PRTH within the spectrum of generalized thyroid hormone resistance.
- Highlights the role of T3 receptor gene mutations in understanding THRS.
- Improves diagnostic and therapeutic approaches for patients with thyroid hormone resistance.