| Approach to the patient with resistance to thyroid hormone and pregnancy. | |
| | |
MedLine Citation:
|
PMID: 20610605 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Resistance to thyroid hormone (RTH), a syndrome of reduced end-organ responsiveness to thyroid hormone (TH), is mostly caused by mutations in the TH receptor (TR) beta gene. Diagnosis is based on persistent elevations of serum free T(4) and often T(3) levels in the absence of TSH suppression, and confirmation in most cases is by way of genetic testing. The mainstay in the management of RTH patients who are asymptomatic is to recognize the correct diagnosis and avoid antithyroid treatment. Deciding whether to manage these patients with TH replacement is made even more challenging when an affected individual is pregnant. How one approaches such a patient with pregnancy and RTH would depend on the genotype of the fetus. This requires obtaining prenatal information on the genotype of the fetus and a thorough history of the outcome of previous pregnancies as well as a history of the course and outcome of other family members with RTH. If the TRbeta mutation is known in the mother, the fetus can be rapidly genotyped from DNA from amniocentesis for the same mutation, and then management decisions could be made regarding thyroid or antithyroid hormone treatment. |
| | |
Authors:
|
Roy E Weiss; Alexandra Dumitrescu; Samuel Refetoff |
Related Documents
:
|
339325 - Gastrin in the human fetus. distribution and molecular forms of gastrin in the antro-py... 8541455 - Thyroid dysfunction: an adolescent gynecologic perspective. 10396355 - Low maternal free thyroxine concentrations during early pregnancy are associated with i... 1422235 - The fetus in maternal hyperthyroidism. 21842665 - Perinatal loss and parental grief: the challenge of ambiguity and disenfranchised grief. 10865185 - Second-trimester levels of maternal serum human chorionic gonadotropin and inhibin a as... |
Publication Detail:
|
Type: Case Reports; Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
|
Title: The Journal of clinical endocrinology and metabolism Volume: 95 ISSN: 1945-7197 ISO Abbreviation: J. Clin. Endocrinol. Metab. Publication Date: 2010 Jul |
Date Detail:
|
Created Date: 2010-07-08 Completed Date: 2010-07-26 Revised Date: 2013-03-28 |
Medline Journal Info:
|
Nlm Unique ID: 0375362 Medline TA: J Clin Endocrinol Metab Country: United States |
Other Details:
|
Languages: eng Pagination: 3094-102 Citation Subset: AIM; IM |
Affiliation:
|
Section of Adult and Pediatric Endocrinology, Diabetes, and Metabolism, Department of Medicine, The University of Chicago, 5841 South Maryland Avenue, MC 3090, Chicago, IL 606037, USA. rweiss@medicine.bsd.uchicago.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Female Humans Mutation Pregnancy Prenatal Diagnosis* Thyroid Hormone Receptors beta / genetics* Thyroid Hormone Resistance Syndrome / blood, genetics, therapy* Thyroxine / blood Triiodothyronine / blood |
| Grant Support | |
ID/Acronym/Agency:
|
DK07011/DK/NIDDK NIH HHS; DK17050/DK/NIDDK NIH HHS; DK20595/DK/NIDDK NIH HHS; RR04999/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/Thyroid Hormone Receptors beta; 6893-02-3/Triiodothyronine; 7488-70-2/Thyroxine |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: High-throughput profiling of amino acids in strains of the Saccharomyces cerevisiae deletion collect...
Next Document: Approach to the patient with type 2 diabetes and progressive kidney disease.