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Pituitary and peripheral resistance to thyroid hormone

, : Pituitary and peripheral resistance to thyroid hormone. Clinical Endocrinology 10(5): 431-442

A 32 yr old Causasian male, clinically euthyroid, with paranoid schizophrenia and granulocytopenia, had elevated total and free serum T4 [thyroxine] and T3 [triiodothyronine]; serum TSH [thyrotropin] was normal (2.7 .+-. 0.7 .mu.U/ml). There was no goiter present, no evidence of Graves' disease and no evidence of pituitary tumor. He had a normal response to methyl-TRH [thyroliberin], with a TSH increment of 14.6 .mu.U[unit]/ml, T3 increment of 212 ng/dl and T4 increment of 4.7 .mu.g/dl; baseline prolactin was normal with a normal response to methyl-TRH. T3 therapy (100 .mu.g/day) decreased the thyroidal radioactive I uptake to less than half the baseline value and decreased the TSH increment in response to methyl-TRH to 4.1 .mu.U/ml. I therapy caused an increase in his baseline TSH with an increase in the TSH response to TSH. The metabolic clearance rates (MCR) and production rates (PR) of T3 and T4 were increased. Baseline serum levels of glycoprotein hormone .alpha.-subunit were normal and showed a slight increase in response to methyl-TRH, similar to normal subjects. This patient has evidence of partial pituitary and peripheral resistance to thyroid hormone; his only evidence for hyperthyroidism is the elevated MCR and PR of T3 and T4.


PMID: 113140

DOI: 10.1111/j.1365-2265.1979.tb02099.x

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