T4 plus T3 treatment in children with hypothyroidism and inappropriately elevated thyroid-stimulating hormone despite euthyroidism on T4 treatment

Hormone Research in Paediatrics

Volumn 73, Issue 2, 2010, Pages 108-114

  Akcay, Teoman ^a   Turan, Serap ^a   Guran, Tulay ^a   Unluguzel, Goksenin ^b   Haklar, Goncagul ^b   Bereket, Abdullah ^a  

^a Department of Pediatrics   (Argentina)

^b MARMARA UNIVERSITY   (Turkey)

Author keywords

Combination treatment; Congenital hypothyroidism; Inappropriate hyperthyrotropinemia; L T4; T4+T3 treatment

Indexed keywords

ALKALINE PHOSPHATASE; BITIRON; FERRITIN; HIGH DENSITY LIPOPROTEIN; LEVOTHYROXINE; LEVOTHYROXINE PLUS LIOTHYRONINE; LIOTHYRONINE; LOW DENSITY LIPOPROTEIN; LOW DENSITY LIPOPROTEIN CHOLESTEROL; OSTEOCALCIN; PROLACTIN; SEX HORMONE BINDING GLOBULIN; THYROID HORMONE; THYROTROPIN; THYROXINE; TRIACYLGLYCEROL; UNCLASSIFIED DRUG;

ADD ON THERAPY; ALKALINE PHOSPHATASE BLOOD LEVEL; ARTICLE; BLOOD PRESSURE; BODY HEIGHT; BODY WEIGHT; CHILD; CLINICAL ARTICLE; CONGENITAL HYPOTHYROIDISM; DRUG DOSE TITRATION; DRUG SUBSTITUTION; DRUG WITHDRAWAL; EUTHYROIDISM; FEMALE; FERRITIN BLOOD LEVEL; FOLLOW UP; FREE LIOTHYRONINE INDEX; FREE THYROXINE INDEX; HUMAN; HYPERTHYROIDISM; INAPPROPRIATE HYPERTHYROTROPINEMIA; LIOTHYRONINE BLOOD LEVEL; LIPID BLOOD LEVEL; LIPOPROTEIN BLOOD LEVEL; MALE; NEGATIVE FEEDBACK; PRESCHOOL CHILD; PRIORITY JOURNAL; PROLACTIN BLOOD LEVEL; PULSE RATE; SCHOOL CHILD; THYROID DISEASE; THYROTROPIN BLOOD LEVEL; THYROXINE BLOOD LEVEL; TRIACYLGLYCEROL BLOOD LEVEL;

CHILD; CHILD, PRESCHOOL; CONGENITAL HYPOTHYROIDISM; FEMALE; HUMANS; HYPERTHYROXINEMIA; MALE; PITUITARY GLAND; THYROID GLAND; THYROTROPIN; THYROXINE; TREATMENT OUTCOME; TRIIODOTHYRONINE;

EID: 77951278909     PISSN: 16632818     EISSN: 16632826     Source Type: Journal    
DOI: 10.1159/000277627     Document Type: Article

References (24)

1. McCrossin RB, Sheffield LJ, Robertson EF: Persisting abnormality in the pituitary-thyroid axis in congenital hypothyroidism; in Stockigt JR, Nagataki S (eds): Thyroid Research VII. Canberra, Journal of the Australian Academy of Science, 1980, pp 37-40.
2. Sack J, Shafrir Y, Urbach D, Amado AO: Thyroid stimulating hormone, prolactin, and growth hormone responses to thyrotropin releasing hormone in treated children with congenital hypothyroidism. Pediatr Res 1985; 19: 1037-1039. (Pubitemid 15240956)
3. Grant DB, Fuggle PW, Smith I: Increased plasma thyroid stimulating hormone in treated congenital hypothyroidism: relation to severity of hypothyroidism, plasma thyroid hormone status, and daily dose of thyroxine. Arch Dis Child 1993; 69: 555-558. (Pubitemid 23355848)
4. Heyerdahl S, Kase BF: Significance of elevated serum thyrotropin during treatment of congenital hypothyroidism. Acta Paediatr 1995; 84: 634-638.
5. Roger PP, Dumont JE: Factors controlling proliferation and differentiation of canine thyroid cells cultured in reduced serum conditions: effects of thyrotropin, cyclic AMP and growth factors. Mol Cell Endocrinol 1984; 36: 79-93.
6. Haymart MR, Repplinger DJ, Leverson GE, Elson DF, Sippel RS, Jaume JC, Chen H: Higher serum TSH level in thyroid nodule patients is associated with greater risks of differentiated thyroid cancer and advanced tumor stage. J Clin Endocrinol Metab 2008; 93: 809-814. (Pubitemid 351398557)
7. Escobar-Morreale HF, Escobar del Rey F, Obregon MJ, Morreale de Escobar G: Only the combined treatment with thyroxine and triiodothyronine ensures euthyroidism in all tissues the thyroidectomized rat. Endocrinology 1996; 137: 2490-2502.
8. Escobar-Morreale HF, Obregon MJ, Escobar del Rey F, Monreale de Escobar G: Replacement therapy for hypothyroidism with thyroxine alone does not ensure euthyroidism in all tissues, as studied in thyroidectomized rats. J Clin Invest 1995; 96: 2828-2838.
9. Pilo A, Iervasi G, Vitek F, Ferdeghini M, Cazzuola F, Bianchi R: Thyroidal and peripheral production of 3,5,3-triiodothyronine in humans by multicompartmental analysis. Am J Physiol 1990; 258:E715-E726. (Pubitemid 20142356)
10. Raza J, Hindmarsh PC, Brook CG: Thyrotoxicosis in children: thirty years experience. Acta Paediatr 1999; 88: 937-941. (Pubitemid 29448255)
11. Siegmund W, Spieker K, Weike AI, Giessmann T, Modess C, Dabers T, Kirsch G, Sanger E, Engel G, Hamm AO, Nauck M, Meng W: Replacement therapy with levothyroxine plus triiodothyronine (bioavailable molar ratio 14: 1) is not superior to thyroxine alone to improve well-being and cognitive performance in hypothyroidism. Clin Endocrinol (Oxf) 2004; 60: 750-757. (Pubitemid 38788084)
12. Toft AD: Thyroid hormone replacement: one hormone or two? N Engl J Med 1999; 340: 469-470.
13. Escobar-Morreale HF, Botella-Carretero JI, Gomez-Bueno M, Galan JM, Barrios V, Sancho J: Thyroid hormone replacement therapy in primary hypothyroidism: a randomized trial comparing L-thyroxine plus liothyronine with L-thyroxine alone. Ann Intern Med 2005; 142: 412-424. (Pubitemid 40365429)
14. Appelhof BC, Fliers E, Wekking EM, Schene AH, Huyser J, Tijssen JG, Endert E, van-Weert HC, Wiersinga WM: Combined therapy with levothyroxine and liothyronine in two ratio's compared with levothyroxine monotherapy in primary hypothyroidism; a double blind, randomized controlled clinical trial. J Clin Endocrinol Metab 2005; 90: 2666-2674. (Pubitemid 40686307)
15. Escobar-Morreale HF, Botella-Carretero JI, Escobar del Rey F, Morreale de Escobar G: Treatment of hypothyroidism with combinations of levothyroxine plus liothyronine. J Clin Endocrinol Metab 2005; 90: 4946-4954. (Pubitemid 41159395)
16. Cassio A, Cacciari E, Cicognani A, Damiani G, Missiroli G, Corbelli E, Balsamo A, Bal M, Gualandi S: Treatment for congenital hypothyroidism: thyroxine alone or thyroxine plus triiodothyronine? Pediatrics 2003; 111: 1055-1060. (Pubitemid 36542621)
17. Silva JE: Pituitary-thyroid relationships in hypothyroidism. Baillières Clin Endocrinol Metab 1988; 2: 541-565.
18. Silva JE, Leonard JL: Regulation of rat cerebrocortical and adenohypophyseal type II 5--deiodinase by thyroxine, triiodothyronine, and reverse triiodothyronine. Endocrinology 1985; 116: 1627-1635.
19. Terasaki T, Pardridge WM: Differential binding of thyroxine and triiodothyronine to acidic isoforms of thyroid hormone binding globulin in human serum. Biochemistry 1988; 27: 3624-3628.
20. Silva JE, Larsen PR: Pituitary nuclear 3,5,3-triiodothyronine and thyrotropin secretion: an explanation for the effect of thyroxine. Science 1977; 198: 617-620. (Pubitemid 8215012)
21. Larsen PR, Silva JE, Kaplan MM: Relationships between circulating and intracellular hormones. Endocrinol Rev 1981; 2: 87-102.
22. Silva JE, Leonard JL, Crantz FR, Larsen PR: Evidence of two tissue specific pathways for in vivo thyroxine 5-deiodination in the rat. J Clin Invest 1982; 69: 1176-1184.
23. Panicker V, Cluett C, Shields B, Murray A, Parnell KS, Perry JR, Weedon MN, Singleton A, Hernandez D, Evans J, Durant C, Ferrucci L, Melzer D, Saravanan P, Visser TJ, Ceresini G, Hattersley AT, Vaidya B, Dayan CM, Frayling TM: A common variation in deiodinase 1 gene DIO1 is associated with the relative levels of free thyroxine and triiodothyronine. J Clin Endocrinol Metab 2008; 93: 3075-3081.
24. Torlontano M, Durante C, Torrente I, Crocetti U, Augello G, Ronga G, Montesano T, Travascio L, Verrienti A, Bruno R, Santini S, D'Arcangelo P, Dallapiccola B, Filetti S, Trischitta V: Type 2 deiodinase polymorphism (threonine 92 alanine) predicts L-thyroxine dose to achieve target thyrotropin levels in thyroidectomized patients. J Clin Endocrinol Metab 2008; 93: 910-913. (Pubitemid 351398572)