[Generalized resistance to thyroid hormones in four patients with nodular goiter]

Generalized resistance to thyroid hormone described by S. Refetoff in 1967 is characterized by the presence of goiter, euthyroidism, increased serum value of thyroid hormones and increased or normal serum TSH concentration. We described four patients treated for nodular goiter, where clinical and biochemical studies before and after triiodothyronine treatment (by increasing doses from 20 micrograms to 100 micrograms daily for 10 days) have made it possible to diagnose the Refetoff syndrome. In each case other causes of the increased T4 level were excluded (i.e. tumour of pituitary gland with the TSH increased, TBG high level syndrome, the presence of anti-T3 and anti-T4).