Pituitary resistance to thyroid hormones: pathophysiology and therapeutic options

Shigematsu, Satoshi; Inaba, Hidefumi; Takei, Masahiro; Takeda, Teiji; Komatsu, Mitsuhisa

doi:10.1007/s12020-011-9538-2

Cited by 10 publications

(4 citation statements)

References 40 publications

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“…Thyroid hormone resistance is usually caused by mutation of the nuclear thyroid hormone receptor beta gene (TR-beta), with a resulting hormone pattern similar to central hyperthyroidism and a split phenotype of clinical thyrotoxicosis with regard to peripheral organs and heterogeneous manifestations at the site of the central nervous system [192, 239]. …”

Section: Allostatic and Pathological Conditionsmentioning

confidence: 99%

TSH and Thyrotropic Agonists: Key Actors in Thyroid Homeostasis

Dietrich

Landgrafe

Fotiadou

2012

Journal of Thyroid Research

116

183

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This paper provides the reader with an overview of our current knowledge of hypothalamic-pituitary-thyroid feedback from a cybernetic standpoint. Over the past decades we have gained a plethora of information from biochemical, clinical, and epidemiological investigation, especially on the role of TSH and other thyrotropic agonists as critical components of this complex relationship. Integrating these data into a systems perspective delivers new insights into static and dynamic behaviour of thyroid homeostasis. Explicit usage of this information with mathematical methods promises to deliver a better understanding of thyrotropic feedback control and new options for personalised diagnosis of thyroid dysfunction and targeted therapy, also by permitting a new perspective on the conundrum of the TSH reference range.

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Section: Allostatic and Pathological Conditionsmentioning

confidence: 99%

TSH and Thyrotropic Agonists: Key Actors in Thyroid Homeostasis

Dietrich

Landgrafe

Fotiadou

2012

Journal of Thyroid Research

116

183

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“…Ultrasound detection of the thyroid revealed diffuse disorders; the thyroid was swelling without any mass detected, suggesting thyroid hypersecretion. To distinguish the syndrome of pituitary resistance to thyroid hormone (PRTH) ( 7 , 8 ), the thyroid hormone receptor genes were examined, and there was no mutation.…”

Section: Case Presentationmentioning

confidence: 99%

Case report: A rare case of thyrotropin-secreting pituitary macroadenoma with diffuse calcification presenting with hyperthyroidism and literature review

Huang

Yan²,

Mao³

et al. 2023

Front. Oncol.

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BackgroundThyroid-stimulating hormone (TSH)-secreting pituitary adenomas (TSHomas) are rare and usually present with hyperthyroidism. Calcification in pituitary tumors is an infrequent finding. Herein, we report an extremely rare case of TSHoma with diffuse calcification.Case descriptionA 43-year-old man was admitted to our department with a complaint of palpitations. An endocrinological examination revealed elevated serum levels of TSH, free triiodothyronine (FT3), and free thyroxin, whereas the physical examination revealed no obvious abnormality. Computerized tomography (CT) showed a sellar mass with diffuse calcification. Contrast-enhanced T1-weighted images revealed a less-enhancing tumor without obvious suprasellar or parasellar expansion. The tumor was completely removed via endoscopic transnasal-sphenoidal surgery. Microscopically, nests of cells were inconspicuous among the diffuse psammoma bodies. Expression of TSH was patchy, and only several TSH-positive cells were observed. Postoperatively, the serum levels of TSH, FT3, and FT4 decreased to their normal range. Follow-up MR images showed no evidence of residual tumor or regrowth after the resection.ConclusionsHerein, we report a rare case of TSHoma with diffuse calcification that presented with hyperthyroidism. A correct and early diagnosis was made according to the European Thyroid Association guidelines. This tumor was completely removed via endoscopic transnasal-transsphenoidal surgery (eTSS), and thyroid function was normalized after the operation.

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“…The revealed pathogenesis of PRTH includes mutations in the thyroid hormone transporters (organic anion transporting polypeptide 14 and monocarboxylate transporter 8), the restricted expression of the deiodinase type 2, and the disruption of specific TRb2 contact mechanisms (Suzuki et al 2011).…”

Section: Mechanismmentioning

confidence: 99%

Thyrotoxicosis with concomitant thyroid cancer

Cheng

Jin

et al. 2019

Endocrine-Related Cancer

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Thyrotoxicosis with concomitant thyroid cancer is rare and poorly recognized, which may result in delayed diagnosis, inappropriate treatment and even poor prognosis. To provide a comprehensive guidance for clinicians, the etiology, pathogenesis, diagnosis and treatment of this challenging setting were systematically reviewed. According to literatures available, the etiologies of thyrotoxicosis with concomitant thyroid cancer were categorized into Graves’ disease with concurrent differentiated thyroid cancer (DTC) or medullary thyroid cancer, Marine–Lenhart Syndrome with coexisting DTC, Plummer’s disease with concomitant DTC, amiodarone-induced thyrotoxicosis with concomitant DTC, central hyperthyroidism with coexisting DTC, hyperfunctioning metastases of DTC and others. The underlying causal mechanisms linking thyrotoxicosis and thyroid cancer were elucidated. Medical history, biochemical assessments, radioiodine uptake, anatomic and metabolic imaging and ultrasonography-guided fine-needle aspiration combined with pathological examinations were found to be critical for precise diagnosis. Surgery remains a mainstay in both tumor elimination and control of thyrotoxicosis, while anti-thyroid drugs, beta-blockers, 131I, glucocorticoids, plasmapheresis, somatostatin analogs, dopamine agonists, radiation therapy, chemotherapy and tyrosine kinase inhibitors should also be appropriately utilized as needed.

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Pituitary resistance to thyroid hormones: pathophysiology and therapeutic options

Cited by 10 publications

References 40 publications

TSH and Thyrotropic Agonists: Key Actors in Thyroid Homeostasis

TSH and Thyrotropic Agonists: Key Actors in Thyroid Homeostasis

Case report: A rare case of thyrotropin-secreting pituitary macroadenoma with diffuse calcification presenting with hyperthyroidism and literature review

Thyrotoxicosis with concomitant thyroid cancer

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