Document Detail

Presence of Brown Adipose Tissue in an Adolescent with Severe Primary Hypothyroidism.
MedLine Citation:
PMID:  24915119     Owner:  NLM     Status:  Publisher    
Context: Brown adipose tissue (BAT) generates heat during adaptive thermogenesis in response to cold temperature. Thyroid hormone (TH) receptors, type 2 deiodinase, and TSH receptors are present on brown adipocytes, indicating that the thyroid axis regulates BAT. It is unknown whether absent TH in humans would down-regulate development of BAT and its thermogenic function. Objective: To examine BAT by magnetic resonance imaging (MRI) and infrared thermal imaging (IRT) in a pediatric patient with severe primary hypothyroidism, pre- and post- TH treatment. Design/setting: Case report with longitudinal follow-up in a tertiary center. Main Outcome Measures: BAT fat fraction (FF) measured by MRI, and skin temperature measured by IRT. Results: An 11.5-y female was severely hypothyroid (TSH 989 μ IU/mL, free T4 0.10 ng/dL, low thyroglobulin 3.0 ng/mL, undetectable thyroid tissue on MRI). Low MRI measures of FF (56.1% ±3.7) indicated that BAT was abundantly present in the supraclavicular fossa. IRT showed higher supraclavicular temperature (36.0°C ±0.16) than the suprasternal area (34.3°C ±0.19). After 2 months of TH replacement she was euthyroid (TSH 4.3 μ IU/mL, free T4 1.49 ng/dL, T3 102 ng/dL) at which time supraclavicular BAT decreased (increased FF 60.7% ±3.8). IRT showed a higher, more homogeneous skin temperature throughout the upper thorax (supraclavicular 37.1°C ±0.23, suprasternal 36.4°C ±0.13). The overall size of the supraclavicular fat depot decreased from 84.79 to 41.21 cm(3). Conclusions: These findings document the presence of BAT and thermogenesis in profound hypothyroidism, and suggest a role for TSH and/or TRH as a potential regulator of BAT.
Mimi S Kim; Houchun H Hu; Patricia C Aggabao; Mitchell E Geffner; Vicente Gilsanz
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-10
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  -     ISSN:  1945-7197     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-6-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  -    
Other Details:
Languages:  ENG     Pagination:  jc20141343     Citation Subset:  -    
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