| Clinical features of primary hyperthyroidism caused by Graves' disease admixed with resistance to thyroid hormone (P453T). | |
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MedLine Citation:
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PMID: 20574139 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A 34-year-old Japanese woman was referred to the hospital because of general fatigue and palpitations. She was diagnosed as having resistance to thyroid hormone (RTH) and Hashimoto's thyroiditis at the age of 28. She felt general fatigue, palpitations, heat intolerance, and sweating for 6 months. Thyroid function tests demonstrated elevated levels of free triidothyronine (T3) and free thyroxine (T4) that were above detectable ranges and a completely suppressed level of TSH that was below the detectable range. Titers of anti-TSH receptor antibody (TRAb) and thyroid-stimulating antibody (TSAb) were positive. A 20-minute Technetium-m99 pertechnetate thyroid uptake imaging study showed an elevated value of 39.53% and a normal-shaped thyroid gland. These results indicated that Graves' disease (GD) caused primary hyperthyroidism. Pituitary and peripheral tissues responded to the presence of excess thyroid hormone in the patient. Oral administration of methimazole was started and continued for 1 year 10 months, after which it was ceased. Two years after the cessation of methimazole treatment, level of free T4 was elevated compared to reference range, but levels of TSH and free T3 were within normal reference ranges. Titers of TRAb and TSAb remained negative for 2 years. These findings indicated that the patient's GD was in remission. In conclusion, it is difficult to make a differential diagnosis between GD with RTH and GD alone if RTH is not diagnosed before the onset of GD. An antithyroid drug is able to cause the remission of GD with RTH. |
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Authors:
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Haruhiro Sato |
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Publication Detail:
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Type: Case Reports; Journal Article; Research Support, Non-U.S. Gov't Date: 2010-06-22 |
Journal Detail:
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Title: Endocrine journal Volume: 57 ISSN: 1348-4540 ISO Abbreviation: Endocr. J. Publication Date: 2010 |
Date Detail:
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Created Date: 2010-09-08 Completed Date: 2010-12-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9313485 Medline TA: Endocr J Country: Japan |
Other Details:
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Languages: eng Pagination: 687-92 Citation Subset: IM |
Affiliation:
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Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan. hrhrsato@is.icc.u-tokai.ac.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Antithyroid Agents / therapeutic use Female Graves Disease / complications*, diagnosis*, drug therapy Hashimoto Disease / complications Humans Immunoglobulins, Thyroid-Stimulating / blood Methimazole / therapeutic use Remission Induction Sodium Pertechnetate Tc 99m / diagnostic use Thyroid Gland / radionuclide imaging Thyroid Hormone Resistance Syndrome / complications*, diagnosis Thyrotropin / blood Thyroxine / blood Triiodothyronine / blood |
| Chemical | |
Reg. No./Substance:
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0/Antithyroid Agents; 0/Immunoglobulins, Thyroid-Stimulating; 0/thyrotropin-binding inhibitory immunoglobulin; 23288-60-0/Sodium Pertechnetate Tc 99m; 60-56-0/Methimazole; 6893-02-3/Triiodothyronine; 7488-70-2/Thyroxine; 9002-71-5/Thyrotropin |
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