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Short stature and thyroxine-binding globulin excess: improvement with triiodothyronine treatment.
Pediatrics. 1988 May; 81(5):674-9.Ped

Abstract

Thyroxine-binding globulin (TBG) excess with increased total thyroxine (T4) and triiodothyronine (T3) levels has not been thought to produce symptoms. We report on a white boy, initially seen at 4.3 years of age and observed for 4 years, who has short stature caused by the excess thyroxine binding. At his initial examination his thyroxine-binding globulin (TBG) levels were elevated (17 mg/dL), and he had a T4 level of 25.8 micrograms/dL, short stature, a bone age of 19 months, normal vital signs, and hyperthyroid-stimulating hormone (TSH) response to thyrotropin-releasing hormone (TRH) testing (maximal value 58 microIU/mL). Results of tests obtained during the next 6 months showed other abnormalities related to thyroid function. Tests showed the following values: T3 412 ng/dL, thyroid uptake 24%, and low T3 resin uptake. They also showed these values: an elevated basal TSH of 8.7 microIU/mL, a slightly low preejection period to left ventricular ejection time ratio of 0.29 (normal 0.35 +/- 0.04), and WISC-R IQ within normal limits. Because of the persistent short stature, T3 supplementation was started at age 7 years and gradually increased to 35 micrograms/d. The patient showed no thyrotoxic symptoms. Serum T4 level decreased from 25.8 to 4.2 micrograms/dL, T3 increased to 1,240 ng/dL, the TRH/TSH test result was suppressed (maximal level 1.8), and the preejection period to left ventricular ejection time ratio decreased to 0.24. Growth velocity increased by 65%. Both of the child's parents had normal thyroid test results. A younger brother also showed similar elevations of TBG level and even greater T4 values (36 micrograms/dL).(ABSTRACT TRUNCATED AT 250 WORDS)

Authors+Show Affiliations

Alain N
Department of Pediatrics, Children's Hospital, Ohio State University, Columbus 43205.
Zipf WB
No affiliation info available

MeSH

Body HeightChild, PreschoolGenes, RecessiveGrowth DisordersHumansMaleThyrotropinThyrotropin-Releasing HormoneThyroxine-Binding ProteinsTriiodothyronineX Chromosome

Pub Type(s)

Case Reports
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

3128768

Citation

Alain, N, and W B. Zipf. "Short Stature and Thyroxine-binding Globulin Excess: Improvement With Triiodothyronine Treatment." Pediatrics, vol. 81, no. 5, 1988, pp. 674-9.
Alain N, Zipf WB. Short stature and thyroxine-binding globulin excess: improvement with triiodothyronine treatment. Pediatrics. 1988;81(5):674-9.
Alain, N., & Zipf, W. B. (1988). Short stature and thyroxine-binding globulin excess: improvement with triiodothyronine treatment. Pediatrics, 81(5), 674-9.
Alain N, Zipf WB. Short Stature and Thyroxine-binding Globulin Excess: Improvement With Triiodothyronine Treatment. Pediatrics. 1988;81(5):674-9. PubMed PMID: 3128768.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Short stature and thyroxine-binding globulin excess: improvement with triiodothyronine treatment. AU - Alain,N, AU - Zipf,W B, PY - 1988/5/1/pubmed PY - 1988/5/1/medline PY - 1988/5/1/entrez SP - 674 EP - 9 JF - Pediatrics JO - Pediatrics VL - 81 IS - 5 N2 - Thyroxine-binding globulin (TBG) excess with increased total thyroxine (T4) and triiodothyronine (T3) levels has not been thought to produce symptoms. We report on a white boy, initially seen at 4.3 years of age and observed for 4 years, who has short stature caused by the excess thyroxine binding. At his initial examination his thyroxine-binding globulin (TBG) levels were elevated (17 mg/dL), and he had a T4 level of 25.8 micrograms/dL, short stature, a bone age of 19 months, normal vital signs, and hyperthyroid-stimulating hormone (TSH) response to thyrotropin-releasing hormone (TRH) testing (maximal value 58 microIU/mL). Results of tests obtained during the next 6 months showed other abnormalities related to thyroid function. Tests showed the following values: T3 412 ng/dL, thyroid uptake 24%, and low T3 resin uptake. They also showed these values: an elevated basal TSH of 8.7 microIU/mL, a slightly low preejection period to left ventricular ejection time ratio of 0.29 (normal 0.35 +/- 0.04), and WISC-R IQ within normal limits. Because of the persistent short stature, T3 supplementation was started at age 7 years and gradually increased to 35 micrograms/d. The patient showed no thyrotoxic symptoms. Serum T4 level decreased from 25.8 to 4.2 micrograms/dL, T3 increased to 1,240 ng/dL, the TRH/TSH test result was suppressed (maximal level 1.8), and the preejection period to left ventricular ejection time ratio decreased to 0.24. Growth velocity increased by 65%. Both of the child's parents had normal thyroid test results. A younger brother also showed similar elevations of TBG level and even greater T4 values (36 micrograms/dL).(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0031-4005 UR - https://www.unboundmedicine.com/medline/citation/3128768/Short_stature_and_thyroxine_binding_globulin_excess:_improvement_with_triiodothyronine_treatment_ DB - PRIME DP - Unbound Medicine ER -