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    Coexistence of THRB and TBG Gene Mutations in a Turkish Family
    (Endocrine Soc, 2013) Ferrara, Alfonso Massimiliano; Cakir, Mehtap; Henry, Phillip H.; Refetoff, Samuel
    Objective: Resistance to thyroid hormone is a syndrome characterized by high serum free T-4 levels and unsuppressed serum TSH concentration. Thyroxine-binding globulin complete deficiency manifests with low serum total T-4 and T-3 levels and normal serum TSH concentration. Our objective is to describe a family with the coexistence of resistance to thyroid hormone and thyroxine-binding globulin complete deficiency. Methods: We conducted clinical studies and genetic analyses. Results: The proband presented with mental retardation, hearing loss, and recurrent upper respiratory tract infections accompanied by high serum levels of TSH, T-3, T-4, and high thyroglobulin antibody titers. His elder sister presented with normal TSH and T-3 and high serum T-4 levels. Both patients were found to be heterozygous for the mutation P453A in the thyroid hormone receptor beta (THRB) gene. One of the proband's brothers had low serum total T-3 and T-4 and normal TSH concentrations, without any clinical manifestations. He was hemizygous for the mutation P50fs51X in the TBG gene. The proband's mother showed slightly elevated TSH, normal total T-3 and T-4, and elevated titers of thyroperoxidase antibodies and thyroglobulin antibodies. She was heterozygous for both THRB and TBG genes mutations. Conclusions: To our knowledge, this is the first report of the coexistence of THRB and TBG gene mutations in the same individual (mother of the proband), whereas other affected family members had only 1 of the 2 genes mutated. The case illustrates the difficulty that might be encountered in the interpretation of thyroid function tests when different genetic defects affecting thyroid function coexist.
  • Küçük Resim Yok
    Öğe
    Coexistence of THRB and TBG Gene Mutations in a Turkish Family
    (Endocrine Soc, 2013) Ferrara, Alfonso Massimiliano; Cakir, Mehtap; Henry, Phillip H.; Refetoff, Samuel
    Objective: Resistance to thyroid hormone is a syndrome characterized by high serum free T-4 levels and unsuppressed serum TSH concentration. Thyroxine-binding globulin complete deficiency manifests with low serum total T-4 and T-3 levels and normal serum TSH concentration. Our objective is to describe a family with the coexistence of resistance to thyroid hormone and thyroxine-binding globulin complete deficiency. Methods: We conducted clinical studies and genetic analyses. Results: The proband presented with mental retardation, hearing loss, and recurrent upper respiratory tract infections accompanied by high serum levels of TSH, T-3, T-4, and high thyroglobulin antibody titers. His elder sister presented with normal TSH and T-3 and high serum T-4 levels. Both patients were found to be heterozygous for the mutation P453A in the thyroid hormone receptor beta (THRB) gene. One of the proband's brothers had low serum total T-3 and T-4 and normal TSH concentrations, without any clinical manifestations. He was hemizygous for the mutation P50fs51X in the TBG gene. The proband's mother showed slightly elevated TSH, normal total T-3 and T-4, and elevated titers of thyroperoxidase antibodies and thyroglobulin antibodies. She was heterozygous for both THRB and TBG genes mutations. Conclusions: To our knowledge, this is the first report of the coexistence of THRB and TBG gene mutations in the same individual (mother of the proband), whereas other affected family members had only 1 of the 2 genes mutated. The case illustrates the difficulty that might be encountered in the interpretation of thyroid function tests when different genetic defects affecting thyroid function coexist.
  • Küçük Resim Yok
    Öğe
    Do We Need to Replace GH to Correct Anemia in Hypopituitarism?
    (Endocrine Soc, 2014) Kulaksizoglu, Mustafa; Ipekci, Suleyman Hilmi; Gonulalan, Gulsum; Ozturk, Mine; Kaya, Ahmet; Gonen, Mustafa Sait; Cakir, Mehtap
    [Abstract Not Availabe]
  • Küçük Resim Yok
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    The Effect of Hypothyroidism on Color Contrast Sensitivity: A Prospective Study
    (Karger, 2015) Cakir, Mehtap; Ozturk, Banu Turgut; Turan, Elif; Gonulalan, Gulsum; Polat, Ilker; Gunduz, Kemal
    Background: Thyroid hormone has been shown to control retinal cone opsin expression, the protein of color vision, in adult rodents. Objectives: The aim of this study was to evaluate the effect of hypothyroidism on color contrast sensitivity in adult overt hypothyroid patients. Methods: Thirtyeight overt hypothyroid (31 females, 7 males) subjects and 20 euthyroid (16 females, 4 males) controls were studied prospectively. Color vision examination was performed by Chromatest, a software program analyzing the tritan (blueyellow) color contrast threshold (tritan CCT) and protan (redgreen) color contrast threshold (protan CCT). Color contrast sensitivity analyses of hypothyroid subjects were performed on admission and after L -thyroxine treatment when biochemical euthyroidism was achieved. Results: After a median period of 90 (90-210) days, 24 (19 females, 5 males) patients were euthyroid and eligible for a second color vision examination. Baseline tritan CCT and protan CCT values were significantly higher in the hypothyroid group compared to euthyroid controls, which clinically translates into impaired color contrast sensitivity (p < 0.001 and p < 0.001, respectively). There was a significant decrease in tritan CCT (p = 0.002) and protan CCT (p < 0.001) values in the hypothyroid group after euthyroidism was achieved, which denotes improvement in color contrast sensitivity. Conclusions: It is a novel finding of the current study that color contrast sensitivity is impaired in hypothyroidism and significantly improves after euthyroidism is achieved. (C) 2015 European Thyroid Association Published by S. Karger AG, Basel