Giusto Cristina, Passeri Marina, Sperti Patrizia, Nardone Isabella, Wolde Sellasie Sium, Zaccaria Simona, Longo Lucia, Lo Deserto Pietro, Amendola Stefano, Uccioli Luigi
Division of Endocrinology and Diabetes, CTO Andrea Alesini Hospital, Department of Biomedicine and Prevention, University Tor Vergata, 00133, Rome, Italy.
University of Rome Tor Vergata Department of Biomedicine and Prevention Rome Italy.
Endocr Metab Immune Disord Drug Targets. 2024 Aug 26. doi: 10.2174/0118715303329834240815193640.
Resistance to thyroid hormone is a rare syndrome characterized by peripheral resistance to thyroid hormones. It is caused by genetic dysfunction of thyroid receptor genes, with Thyroid hormone Receptor-beta (TRβ) being the most prevalent. Affected patients show high thyroid hormone levels and non-suppressed Thyroid-stimulating Hormone (TSH). Syndrome manifestations vary from hyperthyroidism to hypothyroidism depending on the specific mutation.
We, herein, describe the case of a 24-year-old female with a diagnosis of resistance to thyroid hormone from the age of 7. The main symptoms the patients complained about were headaches, palpitations, hyperidrosis, and frequent evacuations with severe underweight. The patient's blood test showed high FT3 and FT4 levels with a non-suppressed TSH. We performed a disease complications screening that revealed mild osteoporosis and normal cardiac activity (the patient was already treated with bisoprolol).
This case illustrates symptoms and complications of resistance to thyroid hormone syndrome, a rare and misdiagnosed condition. In this case report, we describe and explain longterm disease symptoms and their management. The long-term history of our patient's disease adds a more comprehensive evaluation of the syndrome and its consequences, contributing to new insights into the resistance to thyroid hormone syndrome and shedding light on personalized management of its manifestations.
甲状腺激素抵抗是一种罕见的综合征,其特征为外周对甲状腺激素产生抵抗。它由甲状腺受体基因的功能障碍引起,其中甲状腺激素受体β(TRβ)最为常见。受影响的患者表现出甲状腺激素水平升高以及促甲状腺激素(TSH)未被抑制。综合征的表现因具体突变而异,从甲状腺功能亢进到甲状腺功能减退不等。
在此,我们描述一名24岁女性的病例,该患者自7岁起被诊断为甲状腺激素抵抗。患者主诉的主要症状为头痛、心悸、多汗以及频繁排便且体重严重不足。患者的血液检查显示游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4)水平升高,TSH未被抑制。我们进行了疾病并发症筛查,结果显示有轻度骨质疏松且心脏活动正常(患者已接受比索洛尔治疗)。
本病例说明了甲状腺激素抵抗综合征的症状和并发症,这是一种罕见且易被误诊的病症。在本病例报告中,我们描述并解释了该疾病的长期症状及其管理。我们患者的长期病史为该综合征及其后果提供了更全面的评估,有助于对甲状腺激素抵抗综合征有新的认识,并为其表现的个性化管理提供线索。