Thyroid hormone resistance due to a novel mutation in thyroid hormone receptor presenting as attention deficit hyperactivity disorder.

Rini Yadav, Monika Goyal, Anshita Aggarwal, Bindu Kulshreshtha
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Abstract

Resistance to thyroid hormone (RTH) is rare and is characterized by high circulating levels of thyroid hormones in the presence of either normal or elevated thyroid stimulating hormone (TSH) levels. Decreased responsiveness of the peripheral tissues to thyroid hormones owing to defective thyroid receptor function is the underlying cause. RTH is variable in its presentation. We report a 21-year-old man with long-standing attention deficit hyperactivity disorder (ADHD) and learning disabilities. His thyroid function tests showed an increased free T3 and T4 in the presence of a non-suppressed TSH. Other pituitary hormones were normal. Subsequently, a genetic analysis revealed a heterozygous mutation (Pro452Thr) in THRβ gene, establishing the diagnosis of RTH. Thus, this was a RTH presenting as ADHD due to a novel mutation in the thyroid hormone receptor gene.

甲状腺激素抵抗是由于甲状腺激素受体的一种新的突变,表现为注意缺陷多动障碍。
对甲状腺激素(RTH)的抵抗是罕见的,其特征是在正常或升高的促甲状腺激素(TSH)水平存在的情况下,甲状腺激素的高循环水平。由于甲状腺受体功能缺陷导致外周组织对甲状腺激素的反应性降低是其根本原因。RTH的表现形式是可变的。我们报告一位患有长期注意力缺陷多动障碍(ADHD)和学习障碍的21岁男性。他的甲状腺功能检查显示游离T3和T4增加,存在非抑制性TSH。其他垂体激素正常。随后,遗传分析显示THRβ基因杂合突变(Pro452Thr),确定了RTH的诊断。因此,由于甲状腺激素受体基因的新突变,这是一种表现为ADHD的RTH。
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