9 Years Follow-up of a Patient with Pituitary Form of Resistance to Thyroid Hormones (PRTH): Comparison of Two Treatment Periods of D-Thyroxine and Triiodothyroacetic Acid (TRIAC)

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dc.authorid0000-0002-6584-9043
dc.authorid0000-0001-5291-8620
dc.authorid0000-0002-5172-5402
dc.authorscopusid13612528100
dc.authorscopusid57218823942
dc.authorscopusid8416126500
dc.authorscopusid7004903391
dc.authorwosidbereket, abdullah/V-3793-2018
dc.authorwosidBircan, Rıfat/A-7344-2018
dc.authorwosidTuran, Serap/U-7195-2018
dc.contributor.authorGüran, Tülay
dc.contributor.authorTuran, Serap
dc.contributor.authorBircan, Rifat
dc.contributor.authorBereket, Abdullah
dc.date.accessioned2022-05-11T14:28:23Z
dc.date.available2022-05-11T14:28:23Z
dc.date.issued2009
dc.departmentFakülteler, Fen Edebiyat Fakültesi, Biyoloji Bölümü
dc.description.abstractPatients with pituitary resistance to thyroid hormones (PRTH) exhibit features of hyperthyroidism due to normal sensitivity to thyroid hormones in some of the peripheral tissues. There is a lack of information in the literature on the long-term follow-up and treatment of patients with PRTH. Here, we present long-term (9 years) clinical and biochemical follow-up of a patient with PRTH under the treatment of D-T4 initially (for 1.5 years) followed by TRIAC for 5.5 years. An 11.5 year-old girl was evaluated for goiter, palpitations, heat intolerance, sleep disorders, nervousness and frequent stools for 3 years. Her thyroid function tests were consistent with PRTH. Molecular analysis revealed a heterozygous missense mutation of the TR beta gene at codon 243 in exon 7 (R243Q) and a silent mutation at codon 245 in the index patient and the mother who was later also diagnosed to have PRTH. The patient was started on D-T4 treatment since she exhibited clinical symptoms of hyperthyroidism. After 1.5 years, D-T4 treatment was switched to TRIAC which lasted 5.5 years. During the long course of both treatments, thyroid hormones, TSH, heart rate, thyroid size, and markers of peripheral thyroid status (SHBG and alkaline phosphatase) were monitored. It was concluded that compared to D-T4, TRIAC treatment is more effective in suppressing TSH and lowering thyroid hormone levels in PRTH. However, both treatments were unable to reduce thyroid size. The effects of treatment on symptomatology were also modest. Spontaneous improvement in symptoms was observed with age.
dc.identifier.endpage978
dc.identifier.issn0334-018X
dc.identifier.issn2191-0251
dc.identifier.issue10en_US
dc.identifier.pmid20020587
dc.identifier.scopus2-s2.0-71049177020
dc.identifier.scopusqualityQ2
dc.identifier.startpage971
dc.identifier.urihttps://hdl.handle.net/20.500.11776/6807
dc.identifier.volume22
dc.identifier.wosWOS:000272151000015
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorBircan, Rifat
dc.language.isoen
dc.publisherWalter De Gruyter Gmbh
dc.relation.ispartofJournal of Pediatric Endocrinology & Metabolism
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectpituitary resistance to thyroid hormones
dc.subjectD-thyroxine
dc.subjecttriiodothyroacetic acid
dc.subjectTRIAC
dc.subjectHyperthyroidism
dc.subjectTherapy
dc.subjectReceptor
dc.subjectChild
dc.subjectThyrotropin
dc.subjectSecretion
dc.subjectMutation
dc.subjectGene
dc.title9 Years Follow-up of a Patient with Pituitary Form of Resistance to Thyroid Hormones (PRTH): Comparison of Two Treatment Periods of D-Thyroxine and Triiodothyroacetic Acid (TRIAC)
dc.typeArticle

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