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Friday, 29 November 2013

Thyroid Disease : Thyroid hormone resistance syndrome – The Symptoms

Thyroid is one of the largest endocrine glands found in the neck, below the Adam’s Apple with the function of regulating the body use of energy, make of proteins by producing its hormones as a result of the stimulation of thyroid-stimulating hormone (TSH) produced by the anterior pituitary.
Thyroid disease is defined as a condition of malfunction of thyroid. Hyperthyroidism is a condition in which the thyroid gland is over active and produces too much thyroid hormones. Hypothyroidism is a condition in which the thyroid gland is under active and produces very little thyroid hormones. Thyroid cancer is defined as condition in which the cells in the thyroid gland have become cancerous.
Thyroid hormone resistance syndrome
Thyroid hormone resistance syndrome is defined as a condition of which affected individuals have elevated serum thyroid hormone levels and inappropriately normal or elevated thyroid-stimulating hormone (TSH) but are usually clinically euthyroid and require no treatment. Selective pituitary resistance to thyroid hormone (PRTH) is characterized by resistance in the pituitary gland but not in peripheral tissues(a).
A. Symptoms
1. hyperactivity, emotional lability, a below average intelligence quotient, and short stature
Thyroid hormone resistance mutations are associated with a wide variety of phenotypes and subsequent treatment challenges. Among the more common symptoms are hyperactivity, emotional lability, a below average intelligence quotient, and short stature(1).
2. Hyperthyroid symptoms
There is a first case report of a resistance to thyroid hormone in a neonate presenting with hyperthyroid symptoms born to a mother with Graves’ disease and treated with methimazole and iodine(2). such as Sudden weight loss, rapid heartbeat (tachycardia), increased appetite, nervousness, anxiety and irritability, tremor, etc(3).
3. Psychiatric disorders
There is a report of six children from five unrelated families with esistance to thyroid hormone (RTH). All patients grew normally and presented variable symptoms that were treated according to need. Two patients developed psychiatric disorders. Only one of the four affected parents exhibited clinical signs of RTH (tachycardia and depression)(4).
4. Other symptoms
According to the study by the Northwestern University Medical School,, clinical effects of RTH can include short stature, delayed bone maturation, hyperactivity, learning disabilities, and hearing defects, as well as variable features of hyper- and hypothyroidism(5). Others indicated that RTH symptoms include failure to thrive, growth retardation and attention-deficit hyperactivity disorder in childhood, and goitre and thyrotoxic cardiac symptoms in adults(5a).
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Sources
(a) http://www.ncbi.nlm.nih.gov/pubmed/8475937
(1) http://www.ncbi.nlm.nih.gov/pubmed/18622209
(2) http://www.ncbi.nlm.nih.gov/pubmed/22905724
(3) http://www.ncbi.nlm.nih.gov/pubmed/20151830
(4) http://www.ncbi.nlm.nih.gov/pubmed/21870171
(5) http://www.ncbi.nlm.nih.gov/pubmed/8594618
(5a) http://www.ncbi.nlm.nih.gov/pubmed/9350446