Endocrine

, Volume 40, Issue 3, pp 366–371

Pituitary resistance to thyroid hormones: pathophysiology and therapeutic options

  • Satoru Suzuki
  • Satoshi Shigematsu
  • Hidefumi Inaba
  • Masahiro Takei
  • Teiji Takeda
  • Mitsuhisa Komatsu
Mini-Review

DOI: 10.1007/s12020-011-9538-2

Cite this article as:
Suzuki, S., Shigematsu, S., Inaba, H. et al. Endocrine (2011) 40: 366. doi:10.1007/s12020-011-9538-2

Abstract

Thyroid hormone secretion suppresses the expression of thyroid stimulating hormone (TSH), both of which are strictly controlled by a negative feedback loop between the hypothalamus-pituitary and thyroid. Pituitary resistance to thyroid hormone (PRTH) is defined as resistance to the action of thyroid hormone that is more severe in the pituitary than at the peripheral tissue level. Although the molecular basis of PRTH is not well understood, the clinical issue mainly involves imbalance between the hypothalamus-pituitary and peripheral thyroid hormone responsivity, which may induce peripheral thyrotoxic phenomena. Here, we review the pathogenesis and molecular aspects of PRTH, present a single case with inappropriate TSH secretion suffering from thyrotoxicosis treated with PTU, and discuss the possible choice of therapeutic options to correct the imbalance of thyroid hormone responsivity in both the hypothalamus–pituitary and peripheral tissues.

Keywords

PRTH GRH SITSH Deiodinase Propylthiouracil 

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Satoru Suzuki
    • 1
  • Satoshi Shigematsu
    • 1
  • Hidefumi Inaba
    • 1
  • Masahiro Takei
    • 1
  • Teiji Takeda
    • 1
  • Mitsuhisa Komatsu
    • 1
  1. 1.Department of Aging Medicine and Geriatrics, Institute on Aging and AdaptationShinshu University, Graduate School of MedicineMatsumotoJapan