Stagi Stefano, Manoni Cristina, Cirello Valentina, Covelli Danila, Giglio Sabrina, Chiarelli Francesco, Seminara Salvatore, de Martino Maurizio
Hormones (Athens). 2014 Oct-Dec;13(4):561-7. doi: 10.14310/horm.2002.1502. Epub 2014 Nov 5.
The syndrome of resistance to thyroid hormone (RTH) is characterized by elevated serum free thyroid hormones (FT4 and FT3) in the presence of unsuppressed TSH levels, reflecting resistance to the normal negative feedback mechanisms in the hypothalamus and pituitary. The degree of resistance within peripheral tissues determines whether thyrotoxic clinical features are associated with this condition. Classic features include attention deficit hyperactivity disorder, growth delay, tachycardia, and goiter. However, other features, such as frequent ear, nose and throat infections, hearing deficit, and decreased bone mass have recently been recognized. The phenotype of RTH is variable, with most patients presenting with mild to moderate symptoms. In this report we describe a girl with familiar RTH and diabetes mellitus. This is, to our knowledge, the first report regarding this association. Nearly one year after long-term triiodothyroacetic acid (Triac) therapy, we observed a reduction of thyroid hormone levels with an amelioration of insulin resistance. The possible interactions between these disorders are discussed.
甲状腺激素抵抗综合征（RTH）的特征是血清游离甲状腺激素（FT4和FT3）升高，而促甲状腺激素（TSH）水平未被抑制，这反映了下丘脑和垂体对正常负反馈机制的抵抗。外周组织的抵抗程度决定了甲状腺毒症临床特征是否与该病症相关。典型特征包括注意力缺陷多动障碍、生长发育迟缓、心动过速和甲状腺肿大。然而，最近人们认识到了其他特征，如频繁的耳、鼻、喉感染、听力缺陷和骨量减少。RTH的表型各不相同，大多数患者表现为轻度至中度症状。在本报告中，我们描述了一名患有家族性RTH和糖尿病的女孩。据我们所知，这是关于这种关联的首次报告。长期使用三碘甲状腺乙酸（Triac）治疗近一年后，我们观察到甲状腺激素水平降低，胰岛素抵抗得到改善。本文讨论了这些疾病之间可能的相互作用。
