Pituitary resistance to thyroid hormone (PRTH)

What is Pituitary resistance to thyroid hormone (PRTH)

This congenital genetic disorder results in continued thyroid-stimulating hormone (TSH) production driving hypersecretion of T3 and T4 hormones to establish a new equilibrium, with high serum levels of free thyroid hormones together with a nonsuppressed Thyroid stimulating hormone (TSH). 

This condition is caused by mutation in the thyroid hormone receptor gene (THRB).

Pituitary resistance to thyroid hormone presents with thyrotoxic features, which indicates that peripheral tissues are less refractory to thyroid hormones than the pituitary.

Synonyms

  1. Selective pituitary resistance to thyroid hormone
  2. PRTH
  3. Hyperthryoidism, Familial, Due to inappropriate Thyrotropin Secretion
  4. Thyroid Hormone Resistance, Selective Pituatary

Inheritance

Autosomal dominant

Symptoms of PRTH

  • palpitations
  • anxiety
  • tremor
  • heat intolerance
  • insomnia
  • weight loss
  • increased stool frequency

Endocrine symptoms

– Clinical and laboratory features of Hyperthyroidism
– Selective pituitary insensitivity to thyroid hormone

Diagnosis

Increased pituitary thyroid stimulating hormone (TSH)

Prognosis

Prognosis is favorable with treatment

Treatment

  1. Continous therapy with triiodothyronine (T3)
  2. NADH Supplementation
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