Abstract
Therapy of ITSHS, not secondary to a pituitary tumor, has proven difficult and has rarely been completely successful. We report a six yr old with mild symptoms of hyperthyroidism and non-tumorous ITSHS who subjectively and chemically partially responded to exogenous T3. A TRF test showed:
I-131 uptake was 88 and 86% at 4 and 24 hrs; T3 was administered at 25 μg b.i.d., his clinical symptoms subjectively improved, the T3 was slowly increased to 100 μg/day; propranalol was added after a cardiac arrhymia during surgery. A repeat TRF test after 18 months of treatment showed:
Basal T4 remains very high, but the TSH and PROL response are more appropriate. I-131 uptake was 24 and 43% at 4/24 hours. The results are compatible with a generalized resistance of tissues to thyroid hormones. Alternative therapies remain a consideration.
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Liqhtner, E., Magner, J., Petrick, P. et al. 66 INAPPROPRIATE TSH SYNDROME (ITSHS)-TRIIODOTHYRONINE (T3) THERAPY. Pediatr Res 19, 614 (1985). https://doi.org/10.1203/00006450-198506000-00086
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DOI: https://doi.org/10.1203/00006450-198506000-00086