Growth and Development in a Child With Resistance to Thyroid Hormone and Ectopic Thyroid Gland

Abstract

Resistance to thyroid hormone is an uncommon problem, which has rarely been associated with thyroid dysgenesis. We report a case with both thyroid gland ectopy and resistance to thyroid hormone and, thus, a reduced capacity to produce and respond to thyroid hormone. The patient presented at 2 years of age with developmental delay, dysmorphic features, and elevation in both thyroxine and thyrotropin. We document her response to therapy with thyroxine, with particular regard to her growth and development. Persistent elevation of thyrotropin is commonly recognized during treatment of congenital hypothyroidism. Resistance to thyroid hormone may be an important additional diagnosis to consider in cases where thyrotropin remains persistently elevated.

Coexistence of resistance to thyroid hormone and ectopic thyroid: ten-year follow-up

“…The coexistence of RTH and ectopic thyroid is extremely rare and is difficult to distinguish, three cases have been reported (12)(13)(14). Here we describe an unusual patient with RTH and ectopic thyroid.…”

“…LT-4 supplementation was necessary to the RTH patients with hypothyroidism (18)(19)(20). While other patients with RTH rarely require treatment, treatment is clearly necessary in the patient due to the high concentrations of TSH, which may cause further expansion of the lingual thyroid tissue (21).…”

Lingual Thyroid

“…In addition to all these effects, generalised growth and retardation in children have also been reported in a case report by Heather et. al [32].…”

Ectopic thyroid tissue presenting as a cardiac mass

“…Titf1, Foxe1, Pax 8, Hhex and Tshr are required for the normal development of the thyroid gland. Animal studies have suggested that genetic abnormalities in these genes could be associated with abnormal thyroid development and possible thyroid ectopia (5,14).…”