Inappropriate TSH secretion with abnormal thyrotroph sensitivity to dopamine.
A 47-year-old male schizophrenic with hyperthyroidism was found to have non-neoplastic inappropriate thyrotropin (TSH) secretion. Anterior pituitary function, CT scan and alpha subunit determinations were normal. TSH rose after TRH (7.8 to 22.5 microU/ml) and propylthiouracil (26.1 microU/ml after 3 months) and decreased with oral T3 (Cytomel 25 micrograms po q.i.d.). Cytomel and glucocorticoid infusion blunted but did not completely suppress the TSH response to TRH. Intravenous dopamine infusion (4 micrograms/kg/min) completely suppressed the prolactin but not the TSH response to TRH. The association of schizophrenia and differential thyrotroph sensitivity to dopamine suggests a possible role for dopamine in the pathogenesis of selected cases of non-neoplastic inappropriate TSH secretion.
D004298:Dopamine / Q000008:administration & dosage / Q000502:physiology*; D006801:Humans; D006854:Hydrocortisone / Q000494:pharmacology; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D010903:Pituitary Gland, Anterior / Q000378:metabolism*; D011388:Prolactin / Q000378:metabolism; D011441:Propylthiouracil / Q000494:pharmacology / Q000627:therapeutic use; D012559:Schizophrenia / Q000097:blood / Q000150:complications; D013963:Thyroid Hormones / Q000097:blood; D013972:Thyrotropin / Q000378:metabolism*; D013973:Thyrotropin-Releasing Hormone; D014284:Triiodothyronine / Q000097:blood / Q000494:pharmacology
D013963:Thyroid Hormones; D014284:Triiodothyronine; D013973:Thyrotropin-Releasing Hormone; D011441:Propylthiouracil; D011388:Prolactin; D013972:Thyrotropin; D004298:Dopamine; D006854:Hydrocortisone