Bruno R, Giannasio P, Bellitti P, Sinisi R, Arturi F, Russo D, Costante G
Endocrinology Unit, Tinchi Hospital, Matera, Italy.
J Endocrinol Invest. 2005 Jul-Aug;28(7):663-6. doi: 10.1007/BF03347268.
We report a case of a male patient thyroidectomized for follicular thyroid carcinoma and presenting extremely elevated serum thyrotropin levels under L-T4 suppressive therapy. Administration of L-T3 in increasing amounts resulted in a significant decrease of serum TSH levels. The nature of the possible molecular defects underlying this unusual condition and pitfalls arising from the failure of L-T4 therapy to inhibit TSH secretion in a patient in post-surgical follow-up for follicular carcinoma are discussed.
我们报告一例男性患者，因滤泡性甲状腺癌接受甲状腺切除术后，在左甲状腺素（L-T4）抑制治疗下血清促甲状腺激素水平极度升高。给予递增剂量的左三碘甲状腺原氨酸（L-T3）后，血清促甲状腺激素（TSH）水平显著下降。本文讨论了这种异常情况潜在的分子缺陷的性质，以及在滤泡性癌术后随访患者中，L-T4治疗未能抑制TSH分泌所带来的问题。
