title: Pituitary resistance to thyroid hormones: pathophysiology and therapeutic options.
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.
authors.affiliation: Department of Aging Medicine and Geriatrics, Institute on Aging and Adaptation, Shinshu University, Graduate School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan. suzukis@shinshu-u.ac.jp
authors.forename: Satoru
authors.initials: S
authors.lastname: Suzuki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Shigematsu
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Inaba
authors.forename: Masahiro
authors.initials: M
authors.lastname: Takei
authors.forename: Teiji
authors.initials: T
authors.lastname: Takeda
authors.forename: Mitsuhisa
authors.initials: M
authors.lastname: Komatsu
mesh_terms: D013956:Antithyroid Agents / Q000627:therapeutic use; D025461:Feedback, Physiological; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010900:Pituitary Diseases / Q000097:blood / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D010902:Pituitary Gland / Q000503:physiopathology*; D011441:Propylthiouracil / Q000627:therapeutic use; D013961:Thyroid Gland / Q000502:physiology; D013963:Thyroid Hormones / Q000502:physiology*; D013971:Thyrotoxicosis / Q000097:blood / Q000150:complications* / Q000628:therapy; D013972:Thyrotropin / Q000097:blood
chemical_list: D013956:Antithyroid Agents; D013963:Thyroid Hormones; D011441:Propylthiouracil; D013972:Thyrotropin