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Neonatal detection of generalized resistance to thyroid hormone

Journal Article · · JAMA, Journal of the American Medical Association; (United States)
Generalized resistance to thyroid hormone (GRTH) is an inherited disease that is usually suspected when elevated serum thyroid hormone levels are associated with nonsuppressed thyrotropin. Often these test results are obtained because of short stature, decreased intelligence, and/or hyperactivity with learning disability noted in childhood and adolescence, or because of goiter in adulthood. The authors detected GRTH at birth by analysis of blood obtained during routine neonatal screening. The proposita, born to a mother with GRTH, had a thyrotropin level of 26 mU/L and a corresponding thyroxine concentration of 656 nmol/L. Administration of thyroid hormone in doses eightfold to 10-fold above replacement levels were required to reduce serum thyrotropin to normal levels without induction of hypermetabolism. This case, and the retrospective finding of high thyroxine levels in five newborns subsequently diagnosed as having GRTH, suggest that measurement of thyroxine at birth, in conjunction with thyrotropin, could allow the early detection of GRTH.
OSTI ID:
5509047
Journal Information:
JAMA, Journal of the American Medical Association; (United States), Journal Name: JAMA, Journal of the American Medical Association; (United States) Vol. 264:17; ISSN 0098-7484; ISSN JAMAA
Country of Publication:
United States
Language:
English