| Primary hypothyroidism in an adult patient with protein-calorie malnutrition: a study of its mechanism and the effect of amino acid deficiency. | |
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MedLine Citation:
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PMID: 3121981 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A man with diabetes mellitus, chronic hepatitis, chronic pancreatitis, and blind loop syndrome but without any previous thyroid disease developed three episodes of transient primary hypothyroidism associated with protein-calorie malnutrition (PCM). Clinical examinations suggested that this primary hypothyroidism was not caused by chronic thyroiditis, iodine deficiency, or iodine excess. Since the three times association of primary hypothyroidism with PCM suggested the possibility that the primary hypothyroidism was caused by PCM, we have tried to clarify its mechanism. For this purpose we have investigated the change of thyroid functions during protein-calorie repletion and the effect of amino acid deficiency. Total parenteral nutrition with full supplementation of amino acids resulted in a rapid increase in serum thyroxine (T4), triiodothyronine (T3), free T4, and reverse T3, and subsequently, a rapid decrease in TSH in several days after the nutrition was begun. When amino acid solution was changed to that depleted of phenylalanine and tyrosine after the restoration of thyroid functions, serum T4 and T3 showed a gradual decrease, but serum free T4 and TSH remained within normal range. However, resupplementation of phenylalanine and tyrosine after 8 weeks of depletion gave a rapid increase in serum T4, T3, free T4, and reverse T3. These results suggested that the primary hypothyroidism was caused by an impaired T4 production and that the deficiency of amino acids in PCM partly contributed to the impairment of T4 production. |
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Authors:
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Y Tahara; M Hirota; K Shima; S Kozu; H Ikegami; A Tanaka; Y Kumahara; N Amino; S Hayashizaki; K Miyai |
Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Metabolism: clinical and experimental Volume: 37 ISSN: 0026-0495 ISO Abbreviation: Metab. Clin. Exp. Publication Date: 1988 Jan |
Date Detail:
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Created Date: 1988-02-20 Completed Date: 1988-02-20 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0375267 Medline TA: Metabolism Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 9-14 Citation Subset: IM |
Affiliation:
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Department of Medicine, Osaka University Medical School, Japan. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Amino Acids / administration & dosage, deficiency* Humans Hypothyroidism / blood, etiology* Male Parenteral Nutrition, Total Phenylalanine / deficiency Protein-Energy Malnutrition / complications*, physiopathology Thyroid Function Tests Thyrotropin / blood Thyroxine / blood Triiodothyronine / blood Triiodothyronine, Reverse / blood Tyrosine / deficiency |
| Chemical | |
Reg. No./Substance:
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0/Amino Acids; 55520-40-6/Tyrosine; 5817-39-0/Triiodothyronine, Reverse; 63-91-2/Phenylalanine; 6893-02-3/Triiodothyronine; 7488-70-2/Thyroxine; 9002-71-5/Thyrotropin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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