Inappropriate thyroid gland ablation in patients with generalized resistance to thyroid hormone. A common sequela of a rare disorder

Generalized resistance to thyroid hormone is one of several rare disorders of thyroid metabolism that can be associated with confusing symptoms and signs. Five cases of generalized resistance to thyroid hormone that were misdiagnosed with thyrotoxicosis, leading to unnecessary thyroid gland ablation and iatrogenic hypothyroidism, are reviewed herein. These cases illustrate the point that a careful review of the history, physical examination, and laboratory data, as well as an understanding of hormonal feedback relationships, will greatly benefit the practitioner in evaluating the patients with thyroid dysfunction. Consultation with an endocrinologist may be helpful to establish the correct diagnosis and avoid unnecessary treatments.