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Minerva Endocrinologica 2000 March;25(1):29-32

language: English

Abnormally high TSH in subjects with thyrotoxicosis affected by congenital hypothyroidism. Case report

Alberto G. 1, Novi R. F. 1, Trombetta A. 1, Maurino M. 1, Seardo M. A. 1, Brossa C. 1, Messina M. 2

1 From the Department of Internal Medicine, University of Turin;
2 Division of Endocrinology, Maria Vittoria Hospital, Turin


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Inappropriate secre­tion of TSH (IST) ­refers to a het­er­o­ge­ne­ous ­group of syn­dromes in ­which ­patients ­show unsup­pressed TSH lev­els in ­spite of ­high ser­um ­free thy­roid hor­mone con­cen­tra­tions. It has ­been rec­og­nised ­that IST can be due to ­both thy­roid hor­mone resis­tance (RTH) and pitui­tary TSH-secret­ing ­tumours. The for­mer can be gen­er­al­ised (­GRTH) or pitui­tary (PRTH) if the resis­tance is ­more ­severe in the pitui­tary ­than in the ­rest of the tis­sues. This ­case ­report ­points out the per­sis­tence of ­this ­patient’s TSH resis­tance to the inhi­bi­tion of ­high con­cen­tra­tions of cir­cu­lat­ing thy­roid hor­mones ­with ­clear symp­toms of thy­ro­tox­ic­o­sis ­even ­after ­many ­years of replace­ment ther­a­py; it ­also sug­gests ­that in ­this ­case FT4 is the param­e­ter to eval­u­ate the ­therapy’s effec­tive­ness.

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