ID 111299
Author
Aoyama, Mariko Tokushima Municipal Hospital
Keywords
Resistance to thyroid hormone
papillary carcinoma
total thyroidectomy and levothyroxine therapy
Content Type
Journal Article
Description
This is a case of a woman who was diagnosed with resistance to thyroid hormone after total thyroidectomy for thyroid cancer. Preoperative laboratory examination revealed the syndrome of inappropriate secretion of TSH, however, the patient had no thyrotoxic symptoms and no family history. Based on the results of ultrasonography and fine needle aspiration, she was diagnosed with papillary thyroid carcinoma and underwent total thyroidectomy. After the surgery, she received L-T4 therapy, but her TSH levels remained elevated. MRI was performed on the brain, but no lesions were found in the pituitary gland. Therefore, she was tested for TRβ gene, and a previously defined mutation, P453S, was detected. Ultimately, she was diagnosed as RTH and treated with L-T4. In this case, the dose of L-T4 needed to be increased to suppress her TSH levels to the normal range or less, and to prevent stimulating malignant cells. Currently, her dose of L-T4 has been increased, and her TSH levels are still lower than normal, however, she has no thyrotoxic symptoms, recurrence or metastasis of thyroid cancer. The patient is currently under careful observation regarding her circulatory and physiological status. In addition, the results of treatment still need to be monitored and evaluated.
Journal Title
The Journal of Medical Investigation
ISSN
13496867
13431420
NCID
AA11166929
AA12022913
Publisher
Faculty of Medicine Tokushima University
Volume
62
Issue
3-4
Start Page
268
End Page
271
Sort Key
268
Published Date
2015-08
DOI (Published Version)
URL ( Publisher's Version )
FullText File
language
eng
TextVersion
Publisher