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Vol. 67, No. 1, 2007
Issue release date: February 2007
Section title: Novel Insights from Clinical Practice
Horm Res 2007;67:1–6
(DOI:10.1159/000095805)

Unexpected Peripheral Markers of Thyroid Function in a Patient with a Novel Mutation of the MCT8 Thyroid Hormone Transporter Gene

Herzovich V. · Vaiani E. · Marino R. · Dratler G. · Lazzati J.M. · Tilitzky S. · Ramirez P. · Iorcansky S. · Rivarola M.A. · Belgorosky A.
Endocrinology Service, Hospital de Pediatria Garrahan, Buenos Aires, Argentina

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Article / Publication Details

First-Page Preview
Abstract of Novel Insights from Clinical Practice

Received: 3/7/2006
Accepted: 5/15/2006
Published online: 9/15/2006

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 1

ISSN: 1663-2818 (Print)
eISSN: 1663-2826 (Online)

For additional information: http://www.karger.com/HRP

Abstract

The specific thyroid hormone transporter, MCT8, located on the X chromosome, has led to the identification a novel syndrome. The objective is to relate phenotype with several tissue-specific thyroid functions. A 1-year-old boy, who had severe psychological damage and low serum T4, had received l-T4 for 3 months. At admission, body length was normal but weight was low. Off therapy, serum TSH was mildly elevated, serum T4 and free T4 were low, and serum T3 and free T3 were high. Direct sequencing of the MCT8 gene revealed a single nucleotide change that resulted in a novel nonsense mutation at codon 261 (Q261X) in exon 3. Since serum T3 was high, peripheral markers of hyperthyroidism were looked for. Bone age was advanced, despite the presence of malnutrition and low T4. Serum SHBG, a marker of thyroid hormone action in liver, was markedly elevated. Markers of skeletal muscle catabolism, ammonemia and lactic acid, were found to be elevated. The phenotype of MCT 8 mutation might be explained by differences in the entry of thyroid hormones into different cells. In the presence of an inactive MCT8 transporter, the high blood T3 levels might not be enough to prevent brain damage early in life, while they seem to be able to induce a postnatal state of peripheral hyperthyroidism in other tissues, such as liver, bone and skeletal muscle.


Article / Publication Details

First-Page Preview
Abstract of Novel Insights from Clinical Practice

Received: 3/7/2006
Accepted: 5/15/2006
Published online: 9/15/2006

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 1

ISSN: 1663-2818 (Print)
eISSN: 1663-2826 (Online)

For additional information: http://www.karger.com/HRP


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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