title: Retarded bone growth in thyroid hormone resistance. A clinical study of a large family with a novel thyroid hormone receptor mutation.
abstract: OBJECTIVE
  Thyroid hormone resistance (RTH) is characterised by variable tissue hyporesponsiveness to thyroid hormone. The disorder is usually caused by mutations in the thyroid hormone receptor beta (TR beta). We describe a large family with this disorder. SUBJECTS AND MEASUREMENT: We identified 36 family members with RTH in four generations by screening relatives of patients with the diagnosis. The diagnosis was verified by identification of a mutation in the thyroid hormone receptor beta (TR beta) gene. Symptoms, clinical findings and laboratory tests of 29 affected individuals were compared with those of 16 first-degree relatives.
  
  
  RESULTS
  Bone maturation in children with RTH was delayed. The height was lower both in children and in adults with RTH than in the controls. Children with RTH had lower birth weight than the controls, particularly when the condition was inherited from the father. We did not observe increased prevalence of neuropsychological symptoms associated with RTH in this family. Palpitations and increased pulse rate indicated mild cardiac hyperthyroidism. Direct sequence analysis of the TR beta gene revealed a novel point mutation, a heterozygous transition c.1031G>C in exon 9 theoretically substituting Gly344Ala.
  
  
  CONCLUSIONS
  We found evidence of skeletal tissue hypothyroidism that resulted in permanent growth retardation from prenatal to adult life. We found substantial variations in thyroid hormone levels and clinical presentation, but most individuals were without symptoms of thyroid disorder.
authors.affiliation: University of Bergen, Institute for Clinical Medicine and Molecular Medicine, Central Hospital, Children's Department, N-6807 Forde, Norway. per.helge.kvistad@helse-forde.no
authors.forename: Per H
authors.initials: PH
authors.lastname: Kvistad
authors.forename: Kristian
authors.initials: K
authors.lastname: Løvås
authors.forename: Helge
authors.initials: H
authors.lastname: Boman
authors.forename: Ole L
authors.initials: OL
authors.lastname: Myking
mesh_terms: D000293:Adolescent; D000328:Adult; D001827:Body Height; D001846:Bone Development / Q000235:genetics*; D002648:Child; D002675:Child, Preschool; D005192:Family Health; D005260:Female; D006130:Growth Disorders / Q000235:genetics*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010375:Pedigree; D017354:Point Mutation; D011988:Receptors, Thyroid Hormone / Q000235:genetics*; D037042:Thyroid Hormone Receptors beta; D018382:Thyroid Hormone Resistance Syndrome / Q000235:genetics*
chemical_list: D011988:Receptors, Thyroid Hormone; D037042:Thyroid Hormone Receptors beta