Pituitary resistance to thyroid hormones: pathophysiology and therapeutic options

Autor: Satoshi Shigematsu, Teiji Takeda, Hidefumi Inaba, Satoru Suzuki, Mitsuhisa Komatsu, Masahiro Takei
Rok vydání: 2011
Předmět:
Zdroj: Endocrine. 40:366-371
ISSN: 1559-0100
1355-008X
DOI: 10.1007/s12020-011-9538-2
Popis: Thyroid hormone secretion suppresses the expression of thyroid stimulating hormone (TSH), both of which are strictly controlled by a negative feedback loop between the hypothalamus-pituitary and thyroid. Pituitary resistance to thyroid hormone (PRTH) is defined as resistance to the action of thyroid hormone that is more severe in the pituitary than at the peripheral tissue level. Although the molecular basis of PRTH is not well understood, the clinical issue mainly involves imbalance between the hypothalamus-pituitary and peripheral thyroid hormone responsivity, which may induce peripheral thyrotoxic phenomena. Here, we review the pathogenesis and molecular aspects of PRTH, present a single case with inappropriate TSH secretion suffering from thyrotoxicosis treated with PTU, and discuss the possible choice of therapeutic options to correct the imbalance of thyroid hormone responsivity in both the hypothalamus-pituitary and peripheral tissues.
Databáze: OpenAIRE