病例报告。

B. Almacan, N. Ozdemir, H. Gürkan, S. Gul, S. Guldiken, Z. Hekimsoy
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引用次数: 0

摘要

甲状腺激素抵抗(thyroid hormone resistance, RTH)被定义为靶组织对甲状腺激素反应的降低。大多数患者表现出非特异性的发现。在这篇文章中,我们的目标是代表一位22岁的女性患者,她表现出心悸,疲劳和热不耐受。考虑甲状腺激素抵抗,遗传检查显示THRβ基因NM_001128177.1 (THRβ): c.1034G > A (p.Gly345Asp)致病性变异。病例报告一名22岁女性患者,主诉疲劳、热不耐和心悸。入院时,她每天服用两次心得安。她的家族史显示她的祖母有甲状腺功能减退。体检结果:身高160 cm,体重65 kg,体质指数25.4kg/m2,体温36.5℃,呼吸频率18次/min,心率86次/min,血压120/80 mmHg。她的手心出汗了。心音正常,无听诊杂音。实验室结果:TSH: 5.31uU/mL, fT3: 6.83 pg/mL, fT4: 2.43 ng/dL。我们要求对该患者进行THRβ基因突变分析,其临床病史和实验室结果与甲状腺激素抵抗相一致。致病变异NM_001128177.1(THRβ):c。分析后检测到1034G>A (p.Gly345Asp)。结论RTH的诊断需要高度的临床怀疑,临床怀疑时应进行基因突变分析。这样就可以避免不必要的抗甲状腺治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Case Report.
Background Thyroid hormone resistance (RTH) is defined as a decrease in response to thyroid hormones in the target tissue. Most patients present with nonspecific findings. In this article, we aimed to represent a 22-year-old female patient who presented with palpitation, fatigue, and heat intolerance. She was thought to have thyroid hormone resistance and her genetic examination revealed NM_001128177.1 (THRβ): c.1034G > A (p.Gly345Asp) pathogenic variation in the THRβ gene. Case report A 22-year-old female patient presented with complaints of fatigue, heat intolerance and palpitations. She was taking Propranolol twice daily at admission. Her family history revealed hypothyroidism in her grandmother. Her physical examination results were as follows: height 160 cm, weight 65 kg, body mass index 25.4kg/m2, body temperature 36.5°C, respiratory rate 18/min, heart rate 86 beats/min, blood pressure 120/80 mmHg. Her palms were sweaty. The heart sounds were normal, and no heart murmur was auscultated. The laboratory results were TSH: 5.31uU/mL, fT3: 6.83 pg/mL, and fT4: 2.43 ng/dL. THRβ gene mutation analysis was requested for our patient whose clinical history and laboratory results were compatible with thyroid hormone resistance. The pathogenic variation NM_001128177.1(THRβ):c.1034G>A (p.Gly345Asp) was detected after analysis. Conclusion A diagnosis of RTH requires high clinical suspicion and a genetic mutation analysis should be requested in the case of clinical suspicion. In this way, unnecessary anti-thyroid treatment can be prevented.
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