Advertisement

Sign up for our daily newsletter

Advertisement

Bexarotene central hypothyroidism tests: Bexarotene: A Rare Cause of Misleading Thyroid Function Tests

Vishnu Sundaresh has received payment from a patient education research grant from Radius Health Inc; however, it is not related to this manuscript and presents no conflict of interest with the presented case report. In a study in human volunteers, a single dose of bexarotene decreased serum TSH, T 4 , and T 3 levels 7.

William Thompson
Monday, August 26, 2019
Advertisement
  • Biochemistry, cellular and molecular biology, and physiological roles of the iodothyronine selenodeiodinases.

  • Smit, Marcel P.

  • Slow growth in spite of adequate rhGH substitution and normal IGF-I levels is an important clinical marker of central hypothyroidism, therefore a strict monitoring of thyroid function is mandatory in treated children with MPHD. The other pituitary functions were found to be normal.

  • Thyroid hormone-related parameters are given in Table 2.

Patients and Methods

TABLE 2. SmitJohannes W. Thyroid hormone-related parameters.

  • Eur J Endocrinol : —

  • New issue alert.

  • If adrenal function cannot be assessed prior to the start of LT4, prophylactic treatment with steroids is advised. Johannes A.

  • Oxford University Press is a department of the University of Oxford.

  • Serum TSH concentrations remained unaltered after 6-wk bexarotene despite the strong reduction in serum T 4 and T 3 hypothyroidism tests, which indirectly confirms the suppressive effects of bexarotene on TSH secretion. In a series of 84 patients with severe GH deficiency, the authors demonstrate that 30 of them became hypothyroid during the treatment with recombinant hGH, thus confirming previous studies on the subject.

  • We report a case of an year-old Caucasian male with cutaneous T-cell lymphoma CTCL who was treated with bexarotene.

Reversible hypotgyroidism dysfunction after long-term exogenous subclinical hyperthyroidism: a randomized, placebo-controlled study. Biochemistry, cellular and molecular biology, and physiological roles of the iodothyronine selenodeiodinases. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Design and patients: Sixty-six Japanese patients with CTCL were retrospectively investigated by evaluating thyroid function during the early phase of bexarotene therapy. Thyroid hormone-related parameters are given in Table 2. The calculations were performed using SPSS Sign In.

Keywords: bexarotene; central hypothyroidism; cutaneous t-cell lymphoma; mycosis fungoides. Objective: Therapy with the retinoid Bexarotene central hypothyroidism tests receptor agonist bexarotene is associated with hypothyroidism caused by decreased pituitary TSH secretion. P value a. Thyroid hormone-related parameters. Related articles in Web of Science Google Scholar. New issue alert. Download all slides.

Patients and Methods

Permissions Icon Permissions. Article Tests Abstract. SmitJohannes W. Citing articles via Web of Science In one recent study, Koulouri et al identified patients in their hospital with hypothalamic-pituitary lesions and stratified them into high risk and low risk groups for having CH.

  • P value a. The association of nine amino acids with cardiovascular events in Finnish men in a year follow-up study.

  • Theo J.

  • This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Publication types Case Reports.

  • Bexarotene increases uptake of radioiodide in metastases of differentiated thyroid carcinoma. N Engl J Med : —

  • Article Contents Abstract.

Close mobile search navigation Article Navigation. In other studies, the retinoids all-trans retinoic acid and 9-cis retinoic were found to stimulate D3 activity in different cell types but decreased D3 activity in neuroblastoma cells 16 It appears likely that glucuronidation of T 4 is also increased by bexarotene, but this could not be investigated in our patients. Search ADS. J Clin Endocrinol Metab 90 : —

Patient data. Biochemistry, cellular and molecular biology, and physiological roles of the iodothyronine selenodeiodinases. Semin Oncol 33 : S7 — S Patients visited the hospital every week for a physical examination and assessment of laboratory parameters.

Publication types

The evaluation of clinical and other biochemical indices of peripheral thyroid hormone action also have a limited bexarogene in monitoring LT4 treatment in CH patients. These are rare adverse effects of bexarotene treatment and there are a few case reports in literature. Search Menu. Reversible diastolic dysfunction after long-term exogenous subclinical hyperthyroidism: a randomized, placebo-controlled study. T 4 S was prepared by the method of Eelkman Rooda et al.

Drug Metab Dispos 26 : — Bexarotene increases uptake of radioiodide in metastases of differentiated thyroid carcinoma. Citing articles via Web of Science The calculations were performed using SPSS

ALSO READ: Inlaid Amps Must Be Acquired Hypothyroidism

In conclusion, LT4 replacement therapy should be carried out in patients with CH with the following considerations:. Download all slides. LT4 replacement is easily titrated in patients with primary hypothyroidism by measurement of serum TSH levels. In iodine-deficient countries, consider the possible presence of a nodular goiter with autonomous thyroid hormone secretion in order to prevent possible LT4 overtreatment. Bexarotene dose was increased, but LT4 was not increased by the primary physician who relied on TSH level, which was low, and hence the existing LT4 dose was maintained. It appears likely that glucuronidation of T 4 is also increased by bexarotene, but this could not be investigated in our patients. Search ADS.

Clinical characteristics and incidences of benign and malignant insulinoma using hy;othyroidism national inpatient database in Japan. In other studies, the retinoids all-trans retinoic acid iodine intake hypothyroidism 9-cis retinoic were found to stimulate D3 activity in different cell types but decreased D3 activity in neuroblastoma cells 16 The evaluation of clinical and other biochemical indices of peripheral thyroid hormone action also have a limited role in monitoring LT4 treatment in CH patients. The patient continued follow-up visits with 3 months intervals.

Publication types

Concomitant medication. The detection limit of the TSH assay was 0. This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

Their clinical characteristics are presented in Table 1. Email alerts Article activity alert. Receive exclusive offers and updates from Oxford Academic. Romijn, Theo J. Twelve patients were included in the protocol.

ALSO READ: Rhodeygirl Tests For Hypothyroidism

The association of nine amino acids with cardiovascular events in Finnish men in a year follow-up study. The bexarotene central hypothyroidism tests of TSH molecules with reduced bioactivity is a common alteration in the patients with hypothalamic-pituitary lesions, contributing along hypothuroidism the impairment of pituitary TSH reserve to the pathogenesis of CH. CH may present as an isolated finding or may be associated with other pituitary hormone deficiencies. Abstract Bexarotene is a very rare cause of central hypothyroidism CH and its effects have been reported to be dose-dependent; however, the available data in the literature on dose-dependent effects are variable. The mechanism by which bexarotene can cause central hypothyroidism is not completely understood but is postulated to be secondary to direct suppression of TSH subunit synthesis, TSH secretion, and TSH clearance [ 4 ].

Although mutations in the centtral encoding TSH beta subunit are rare, this publication suggests a series of clinical and biochemical characteristics to reach a precise diagnosis. In conclusion, in the present study, we demonstrated that increased peripheral degradation of thyroid hormones in addition to decreased TSH secretion contributes to bexarotene-induced hypothyroidism. Registration is free. The institutional review board approved the study, and all patients gave written informed consent. Here we report our patient with Sezary syndrome who was treated with bexarotene, which had side effects ofsevere central hypothyroidism and mixed hyperlipidemia. We could maintain bexarotene therapy in this patient with euthyroid state and normal lipid levels.

In addition, activating angiopoietin-like protein 3 in vivo and apoCIII in vitrofactors that are both inhibitors of the TG-hydrolyzing activity of lipoprotein lipase, could affect TG clearance [ 6 ]. Exclusion criteria were pregnancy, contraindications for the application of recombinant human TSH rhTSHand contraindications for the use of bexarotene. However, several recent papers regarding replacement LT4 therapy in patients with CH have outlined some of the problems in achieving optimal replacement. His pre-treatment TSH was normal at 1. Three patients had a history of hypercholesterolemia, which was treated with cholesterol synthesis inhibitors.

Effects of rexinoids on deiodinases have been described in experimental studies: Machia et al. Johannes W. Open in new tab. Eventually, total triiodothyronine T 3 dropped to a low level of 0. Google Scholar PubMed.

Cardiovascular bexarotenne in thyroid cancer patients treated with thyroidectomy: A meta-analysis. T 4 S decreased after treatment with bexarotene. Google Scholar Crossref. The symptoms of hypothyroidism improved after normalizing fT 4with an increase in the LT4 dose. We therefore studied the effects of bexarotene, administered for 6 wk, on peripheral thyroid hormone metabolism in athyreotic humans with stable thyroid hormone substitution.

Serum thyroid hormone-binding globulin levels remained unaltered. The present investigation was conducted to study the contribution of altered peripheral metabolism of thyroid hormones to bexarotene-induced hypothyroidism. The symptoms of hypothyroidism improved after normalizing fT 4with an increase in the LT4 dose. Design and patients: Sixty-six Japanese patients with CTCL were retrospectively investigated by evaluating thyroid function during the early phase of bexarotene therapy. Oxford Academic. Patients visited the hospital every week for a physical examination and assessment of laboratory parameters. Abstract Bexarotene is a very rare cause of central hypothyroidism CH and its effects have been reported to be dose-dependent; however, the available data in the literature on dose-dependent effects are variable.

  • Patients with central hypothyroidism usually display mild to moderate symptoms and signs similar to those of primary hypothyroidism, which include fatigue, constipation, dry skin and weight gain. Citing articles via Web of Science

  • Sign In or Create an Account.

  • Bexarotene is a synthetic retinoid X receptor RXR -selective retinoid recently approved for treatment of cutaneous T-cell lymphoma. Nat Clin Pract Endocrinol Metab.

  • Thyroid hormone-related parameters.

  • Receive exclusive offers and updates from Oxford Academic. The data of this patient were not included in the analyses.

It appears likely that glucuronidation of T 4 is also increased by bexarotene, but this could not be investigated in our patients. Thyroid hormone-related parameters are given in Table 2. Recombinant human TSH was administered before and in the sixth week of bexarotene therapy. The patient had persistent symptoms of hypothyroidism and, eventually, a diagnosis of CH was made.

Patient data. Article Navigation. TABLE 2. Sign In. Oxford University Press is a department of the University of Oxford.

Want to read more?

J Endocrinol 73 : — It appears likely that glucuronidation of T 4 is also bexarotene central hypothyroidism tests by bexarotene, but this could not be investigated in our patients. No differences were observed in serum glucose levels 5. Two patients had well-controlled hypertension, one patient had well-controlled ischemic heart disease, and one patient had obstructive pulmonary disease.

Moreover, the presence of signs and symptoms of other pituitary hormone deficiencies may mask underlying CH. In the evaluation of the adequacy of L-T4 replacement therapy, both serum FT4 and TSH levels together with some biochemical indexes of thyroid hormone action appear necessary to a more accurate disclosure of over- or under- treated patients. Hence, those patients who are treated with this agent must be followed for these serious adverse effects. The study results with respect to radioiodine uptake have been published previously 2. Show More.

Hypothyroidism tests TSH concentrations remained unaltered after 6-wk bexarotene despite the strong reduction in serum T 4 and T 3 levels, which indirectly confirms the suppressive effects of bexarotene on TSH secretion. No differences were observed in serum glucose levels 5. Exclusion criteria were pregnancy, contraindications for the application of recombinant human TSH rhTSHand contraindications for the use of bexarotene. We therefore studied the effects of bexarotene, administered for 6 wk, on peripheral thyroid hormone metabolism in athyreotic humans with stable thyroid hormone substitution.

Hypoxia-inducible factors individually facilitate inflammatory myeloid metabolism and inefficient cardiac repair. Bexarotene central hypothyroidism tests of thyroxine-sulfate T4S in human serum and amniotic fluid by a novel T4S radioimmunoassay. Other diagnoses. Eur J Endocrinol : — J Clin Endocrinol Metab 90 : —

Download all slides. Email alerts Article activity alert. Please login or register first to view this content. The detection limit of the TSH assay was 0.

  • Marcel P. In addition, bexarotene also has effects on metabolic pathways such as insulin sensitivity 3.

  • Before bexarotene and in the last week of bexarotene therapy, the patients received two injections of 0.

  • Oxford University Press is a department of the University of Oxford. Three patients had a history of hypercholesterolemia, which was treated with cholesterol synthesis inhibitors.

  • Retinoid receptors belong to the family of nuclear receptors and can be distinguished in retinoic acid receptors and retinoid X receptors.

  • Conclusions: Preventive treatment with levothyroxine is recommended for Japanese CTCL patients prior to bexarotene therapy.

Slow growth in spite of adequate rhGH substitution and normal Bexarotene central hypothyroidism tests levels is an important clinical marker of central hypothyroidism, therefore a strict monitoring of thyroid function is mandatory in treated children hypothyrroidism MPHD. Endocr Rev 23 : 38 — They were assessed every week. Treatment of patients with bexarotene-induced hypothyroidism commonly requires high doses of thyroid hormone for replacement therapy, often twice the typical doses used to treat more common etiologies of hypothyroidism. Email alerts Article activity alert. They conclude that GH deficiency may mask central hypothyroidism and that patients with FT4 values in the lower limit of the normal range should be treated with LT4 prior to commencement of GH replacement. Login Register.

Search ADS. Recombinant human TSH was administered before hypothyroieism in the hypothyroidism tests week of bexarotene therapy. This is an updated review on LT4 replacement therapy in patients with congenital primary or central hypothyroidism. Concomitant medication. Are you sure the patient has Central Hypothyroidism? Semin Oncol 33 : S7 — S Activation and induction properties—relation with thyroxine plasma disappearance rate.

Email alerts Article activity alert. Sign In. Thyroid hormone-related parameters. Management of the adverse events could be done by nicotinic acid or fenofibrates, statins and L-thyroxin replacement.

Some patients with CH with a predominantly hypothalamic defect may have high serum TSH levels, a potentially misleading diagnosis which may be confused with subclinical primary hypothyroidism. Clinical characteristics and incidences of benign and malignant insulinoma using a bexarotene central hypothyroidism tests inpatient database in Japan. In this case we managed the patient by nicotinic acid, statin and L-thyroxin for 2 years. If adrenal function cannot be assessed prior to the start of LT4, prophylactic treatment with steroids is advised. In patients who develop hypothyroidism during bexarotene therapy, it should be realized that TSH measurements are unreliable to monitor l -T 4 substitution therapy and that higher l -T 4 dosages may be required than expected because of the enhanced degradation of thyroid hormones.

J Immunoassay 9 : — Age yr. Patients visited the hospital every week for a physical examination and assessment of laboratory parameters. TABLE 2.

  • The symptoms of hypothyroidism improved after normalizing fT 4with an increase in the LT4 dose.

  • Abstract Bexarotene is a very rare cause of central hypothyroidism CH and its effects have been reported to be dose-dependent; however, the available data in the literature on dose-dependent effects are variable.

  • On laboratory examination, anterior pituitary hormones were completely normal except thyroid-stimulating hormone TSH level.

  • Eventually, total triiodothyronine T 3 dropped to a low level of 0. Induction of type III-deiodinase activity in astroglial cells by retinoids.

The association of hypothyroidism tests amino acids with cardiovascular events in Finnish men in a year follow-up study. Minimally, it should be considered for patients with a pretreatment TSH above 1. Marcel P. Two patients had well-controlled type 2 diabetes mellitus.

The association of nine amino acids with cardiovascular events in Finnish men in a year follow-up study. Romijn, Theo J. Metabolism of thyroid hormones is mediated by iodothyronine deiodinases D1, D2, and D3 15 and by hepatic conjugating enzymes 9. His pre-treatment TSH was normal at 1.

Issue Section:. N Engl J Med : — Pereira, Johannes A.

These observations suggest that bexarotene probably has two fundamental effects on thyroid function: to suppress TSH production and to increase thyroid hormone hypoghyroidism clearance. Abstract Bexarotene is a synthetic retinoid X receptor RXR -selective retinoid recently approved for treatment of cutaneous T-cell lymphoma. Using their department's clinical information system, bexwrotene authors identified all patients with a diagnosis of any type of pituitary tumour who had been seen in clinic over a 2-year period. The alternative explanation, that bexarotene had interfered with the intestinal absorption of l -T 4 is unlikely, because the interval between bexarotene and l -T 4 intake was approximately 12 h but cannot entirely ruled out. We could maintain bexarotene therapy in this patient with euthyroid state and normal lipid levels. The standard practice of monitoring thyroid function using thyroid-stimulating hormone TSH to adjust levothyroxine LT4 dose does not apply to bexarotene since it causes CH. Patients visited the hospital every week for a physical examination and assessment of laboratory parameters.

ALSO READ: Secondary Hypothyroidism Nbme 15 Correlation

In iodine-deficient countries, consider the possible bbexarotene of a nodular goiter with autonomous thyroid hormone secretion in order to prevent possible LT4 overtreatment. TBG, Thyroid hormone binding globulin. Click to view. Serum thyroid hormone-binding globulin levels remained unaltered. Romijn, Theo J. Before bexarotene and in the last week of bexarotene therapy, the patients received two injections of 0.

Romijn, Theo J. Disorders affecting either the pituitary or the hypothalamus may cause hypothyroidism due to insufficient thyrotropin TSH stimulation of an otherwise normal thyroid gland. Biochem Pharmacol 43 : — Age yr. Abstract Bexarotene is a synthetic retinoid X receptor RXR -selective retinoid recently approved for treatment of cutaneous T-cell lymphoma. Advanced Search. Post-bexarotene, the total tetraiodothyronine T 4 level was within the reference range, but a downward trend was noted.

Their clinical characteristics are presented in Table 1. Romijn, Theo J. Endocrinology : — Search Menu. The present investigation was conducted to study the contribution of altered peripheral metabolism of thyroid hormones to bexarotene-induced hypothyroidism. J Endocrinol 73 : —

Patient data. Eur J Endocrinol. The authors suggest to maintain the tests of circulating FT4 in the middle of the laboratory reference values. Their clinical characteristics are presented in Table 1. Cardiovascular outcomes in thyroid cancer patients treated with thyroidectomy: A meta-analysis.

High-density lipoprotein cholesterol was unaffected 1. Conclusions: Preventive bexarotene central hypothyroidism tests with levothyroxine is recommended for Japanese CTCL patients prior to bexarotene therapy. Semin Oncol 33 : S7 — S Two patients had well-controlled type 2 diabetes mellitus. Histology, pTNM.

Alberto M. The detection limit of the TSH assay was 0. Thyroid hormones. It appears likely that glucuronidation of T 4 is also increased by bexarotene, but this could not be investigated in our patients. Therapy with bexarotene is accompanied by central hypothyroidism 4. Post-bexarotene, the total tetraiodothyronine T 4 level was within the reference range, but a downward trend was noted. Smit, Marcel P.

TBG, Thyroid hormone binding globulin. The patient had persistent symptoms of hypothyroidism and, eventually, a diagnosis of CH was made. Theo J. Keywords: bexarotene; central hypothyroidism; cutaneous t-cell lymphoma; mycosis fungoides.

Baris Sariakcali was the treating physician of the patient. The calculations were performed using SPSS Moreover, the presence of signs and symptoms of other pituitary hormone deficiencies may mask underlying CH. Serum thyroid hormone-binding globulin levels remained unaltered. Biochem Pharmacol 43 : —

Bexarotene increases bexwrotene of radioiodide in metastases of differentiated thyroid carcinoma. Johannes A. The study results with respect to radioiodine uptake have been published previously 2. In patients who develop hypothyroidism during bexarotene therapy, it should be realized that TSH measurements are unreliable to monitor l -T 4 substitution therapy and that higher l -T 4 dosages may be required than expected because of the enhanced degradation of thyroid hormones. The patient had persistent symptoms of hypothyroidism and, eventually, a diagnosis of CH was made. T 4 S was prepared by the method of Eelkman Rooda et al.

One patient underwent acute surgery for intestinal volvulus. Tests patients had well-controlled type 2 diabetes mellitus. Search ADS. Minimally, it should be considered for patients with a pretreatment TSH above 1. We assessed T 4 S as an indicator for the sulfation pathway.

View Metrics. Cite Cite Hypothyroidism tests W. Although central hypothyroidism through decreased TSH synthesis by bexarotene has been well established in experimental studies 561314 and in humans 47these studies could not exclude that altered peripheral metabolism of thyroid hormone could also contribute to bexarotene-induced hypothyroidism. To study nondeiodinase-mediated thyroid hormone degradation, serum levels of T 4 sulfate T 4 S were measured. Cardiovascular outcomes in thyroid cancer patients treated with thyroidectomy: A meta-analysis.

ALSO READ: Mitsubishi 120 Excavator Weight

Article Contents Abstract. We had to treat the patients with niascore and atorvastatin as well as T4 replacement. The secretion of TSH molecules with reduced bioactivity is a common alteration in the patients with hypothalamic-pituitary lesions, contributing along with the impairment of pituitary TSH reserve to the pathogenesis of CH. In clinical trials, bexarotene was found to cause severe central hypothyroidism with high frequency, associated with marked reductions in serum concentrations of thyroid-stimulating hormone TSH and thyroxine. Periodic laboratory follow-up including lipid profile and thyroid functions were performed. Abstract Bexarotene is a synthetic retinoid X receptor RXR -selective retinoid recently approved for treatment of cutaneous T-cell lymphoma.

Keywords: bexarotene; central hypothyroidism; cutaneous t-cell lymphoma; mycosis fungoides. Download all slides. Objective: Bexarotene central hypothyroidism tests with the retinoid X receptor agonist bexarotene is associated with hypothyroidism caused by decreased pituitary TSH secretion. Hypoxia-inducible factors individually facilitate inflammatory myeloid metabolism and inefficient cardiac repair. Publication types Review. Please login or register first to view this content. Skip Nav Destination Article Navigation.

View Metrics. His pre-treatment TSH was normal at 1. TABLE 2. Twelve patients were included in the protocol.

  • Patient no.

  • Patients visited the hospital every week for a physical examination and assessment of laboratory parameters. T 4 S was prepared by the method of Eelkman Rooda et al.

  • Dynamic testing should be considered. No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC.

  • Indeed, the net effects of bexarotene on peripheral metabolism of thyroid hormones can only be studied in athyreotic subjects.

  • Oxford University Press is a department of the University of Oxford. In conclusion, in the present study, we demonstrated that increased peripheral degradation of thyroid hormones in addition to decreased TSH secretion contributes to bexarotene-induced hypothyroidism.

T 4 S was prepared by the method of Eelkman Rooda et al. His pre-treatment Bexarotene central hypothyroidism tests was normal at 1. Age yr. Therapy with bexarotene is accompanied by central hypothyroidism 4. They conclude that GH deficiency may mask central hypothyroidism and that patients with FT4 values in the lower limit of the normal range should be treated with LT4 prior to commencement of GH replacement. Patient no.

Effects of rexinoids on deiodinases have been iodine intake hypothyroidism in experimental studies: Machia et al. Cite Cite Johannes W. Biochemistry, cellular and molecular biology, and physiological roles of the iodothyronine selenodeiodinases. T 4 sulfate T 4 S was measured as a marker for T 4 degradation. Alberto M.

Although central hypothyroidism through decreased TSH synthesis by bexarotene has been well established in experimental studies 561314 and in humans 47these studies could not exclude that altered peripheral metabolism of thyroid hormone could also contribute to bexarotene-induced hypothyroidism. The remaining 21 cases showed euthyroidism at 1 week, at which TSH values may roughly predict their thyroid function at 1 month at a cut-off value of 0. Volume Theo J. The detection limit of the TSH assay was 0.

J Clin Endocrinol Metab 92 : — Concomitant medication. Article Navigation.

Cardiovascular outcomes in iodine intake hypothyroidism cancer patients treated with thyroidectomy: A meta-analysis. Bexarotrne patients who develop hypothyroidism during bexarotene therapy, it should be realized that TSH measurements are unreliable to monitor l -T 4 substitution therapy and that higher l -T 4 dosages may be required than expected because of the enhanced degradation of thyroid hormones. Search ADS. Google Scholar Crossref.

Cite Cite Johannes W. Because the T 4 dose was kept stable during the study, increased metabolism of thyroid hormones is the most likely explanation. Advanced Search. The institutional review board approved the study, and all patients gave written informed consent.

Login Register. Patient no. No differences were observed in serum glucose levels 5. Therapy with bexarotene is accompanied by central hypothyroidism 4.

Using their department's clinical information system, the authors identified all patients with a diagnosis of any type of pituitary tumour who had been seen centrwl clinic over a 2-year period. Grant support. Exclusion criteria were pregnancy, contraindications for the application of recombinant human TSH rhTSHand contraindications for the use of bexarotene. The calculations were performed using SPSS Biochemistry, cellular and molecular biology, and physiological roles of the iodothyronine selenodeiodinases. His pre-treatment TSH was normal at 1. Regulation of type III iodothyronine deiodinase expression in human cell lines.

ALSO READ: Primary Hypothyroidism Differential Diagnosis

Identification of thyroxine-sulfate T4S in human serum and amniotic fluid tests a novel T4S radioimmunoassay. Central hypothyroidism associated with retinoid X receptor-selective ligands. This study aimed fests characterize the kinetics and dose dependency of bexarotene-induced CH in Japanese patients. We assessed T 4 S as an indicator for the sulfation pathway. Post-bexarotene, the total tetraiodothyronine T 4 level was within the reference range, but a downward trend was noted. T 4 S decreased after treatment with bexarotene. Effects of rexinoids on deiodinases have been described in experimental studies: Machia et al.

Mol Cell Endocrinol : — Central hypothyroidism tests associated with retinoid Hypohyroidism receptor-selective ligands. The symptoms of hypothyroidism improved after normalizing fT 4with an increase in the LT4 dose. No human studies have been published to address the effects of bexarotene on peripheral thyroid hormone metabolism. Male rat hepatic UDP-glucuronosyltransferase activity toward thyroxine. Exclusion criteria were pregnancy, contraindications for the application of recombinant human TSH rhTSHand contraindications for the use of bexarotene.

These are rare adverse effects of bexarotene treatment and there are a few case reports in literature. Oxford University Press is a department of the University of Oxford. Clin Endocrinol Oxf. The standard practice of monitoring thyroid function using thyroid-stimulating hormone TSH to adjust levothyroxine LT4 dose does not apply to bexarotene since it causes CH.

Mol Endocrinol 11 : — In other studies, the retinoids all-trans retinoic acid bexarotene central hypothyroidism tests 9-cis retinoic were found to stimulate D3 activity in different cell types but decreased D3 activity in neuroblastoma cells 16 T 4 S was prepared by the method of Eelkman Rooda et al. RXR receptor agonist suppression of thyroid function: central effects in the absence of thyroid hormone receptor. TABLE 2.

Single-dose rexinoid rapidly and specifically suppresses serum thyrotropin in normal subjects. Hypothyroidism tests Cite Johannes W. TABLE 1. His pre-treatment TSH was normal at 1. TABLE 2. Keywords: RXR agonist; bexarotene; central hypothyroidism; cutaneous T-cell lymphoma; levothyroxine; preventive treatment; thyroid hormone metabolism. Citing articles via Web of Science

Hypoxia-inducible factors individually facilitate inflammatory myeloid metabolism and inefficient cardiac repair. The secretion of TSH molecules with reduced bioactivity is a common alteration in the patients with hypothalamic-pituitary lesions, contributing along with the impairment of pituitary TSH reserve to the pathogenesis of CH. A study in bexarotene central hypothyroidism APO E2 knock-in mice showed that bexarotene increased the expression of hepatic genes involved in triglyceride TG synthesis and very low-density lipoprotein VLDL production. Levothyroxine doses were generally under-replaced in pituitary patients compared to primary thyroid disease and the data imply that some untreated patients were actually TSH deficient. The detection limit of the TSH assay was 0. Volume 4, Number 4, Augustpages Finally, many drugs including cocaine, somatostatin analogs, glucocorticoids, dopaminergic compounds, and bexarotenemay affect the neuroendocrine mechanisms of TSH regulation to produce a form of CH.

Cardiovascular outcomes in thyroid cancer patients bexarotene central hypothyroidism tests with thyroidectomy: A meta-analysis. Effects of rexinoids on deiodinases have been described in experimental studies: Machia et al. The present investigation was conducted to study the contribution of altered peripheral metabolism of thyroid hormones to bexarotene-induced hypothyroidism. No differences were observed in serum glucose levels 5.

Forty-five study cases showed this effect at 1 week. Recombinant human TSH was administered before and in the sixth week of bexarotene therapy. J Endocrinol 73 : — Grant support.

Using their department's clinical information system, the authors identified all patients with a diagnosis of any type of pituitary tumour who had been seen in clinic over tests 2-year period. The study results with respect to radioiodine uptake have been published previously 2. Search Menu. Stokkel, Alberto M. It is recommended as a second-line therapy for the treatment of mycosis fungoides and Sezary syndrome in a number of national and international guidelines [ 23 ]. Bexarotene is a retinoid X receptor-selective retinoid a rexinoidwhich is approved in the US for the treatment of cutaneous manifestations of cutaneous T-cell lymphoma CTCL in patients refractory to at least one prior systemic therapy and in Europe for the treatment of patients with skin manifestations of advanced-stage CTCL refractory to at least one systemic therapy [ 12 ].

ALSO READ: Hypothyroidism In Dogs And Weight Loss

All patients were in a good physical condition eight patients had Karnofsky score 0; two patients had hypoghyroidism 1. The patient had bexarotene central symptoms of hypothyroidism and, eventually, a diagnosis of CH was made. Clinical characteristics and incidences of benign and malignant insulinoma using a national inpatient database in Japan. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Eventually, total triiodothyronine T 3 dropped to a low level of 0.

To evaluate the effects of bexarotene on peripheral thyroid hormone metabolism, we performed a study in athyreotic subjects on hypothyroiism fixed substitution dose with l -T 4. Select Format Select format. Endocrinology : — Concomitant medication. Forty-five study cases showed this effect at 1 week. Article Navigation. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide.

  • The present investigation was conducted to study the contribution of altered peripheral metabolism of thyroid hormones to bexarotene-induced hypothyroidism.

  • J Immunoassay 9 : —

  • Measurement of anti-thyroid autoantibodies may help in differentiating CH from primary hypothyroidism, as they will be undetectable in patients with CH.

  • Citing articles via Web of Science Pereira, Johannes A.

We therefore studied the effects of bexarotene, administered for 6 wk, on peripheral thyroid hypoyhyroidism metabolism in athyreotic humans with stable thyroid hormone substitution. Bexarotene is also investigated for other malignancies, including thyroid carcinoma 2. J Endocrinol 73 : — Indeed, the net effects of bexarotene on peripheral metabolism of thyroid hormones can only be studied in athyreotic subjects. Exclusion criteria were pregnancy, contraindications for the application of recombinant human TSH rhTSHand contraindications for the use of bexarotene. Thyroid hormone-related parameters are given in Table 2. Two patients had well-controlled type 2 diabetes mellitus.

Oxford University Press hypothyroidism tests a department of the University of Oxford. Romijn, Theo J. Concomitant medication. It appears likely that glucuronidation of T 4 is also increased by bexarotene, but this could not be investigated in our patients.

Cardiovascular outcomes in thyroid bexarotene central hypothyroidism tests patients treated bexarotehe thyroidectomy: A meta-analysis. Therapy with bexarotene is accompanied by central hypothyroidism 4. In addition to these observations, rexinoids may influence peripheral thyroid hormone metabolism through increased or decreased type 1 deiodinase activity or by the induction of hepatic detoxification enzymes [ 15 ]. The symptoms of hypothyroidism improved after normalizing fT 4with an increase in the LT4 dose.

Email alerts Article activity alert. To evaluate the effects of bexarotene central hypothyroidism tests on peripheral thyroid hormone metabolism, we performed a study in athyreotic subjects on a fixed substitution dose with l -T 4. Drug Metab Dispos 26 : — Thyroid hormones.

It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Clinical and hormonal data were consistent with the central hypothyroidism. The diagnosis is usually obtained on a biochemical basis either incidentally or in patients under evaluation for hypothalamic or pituitary disorders. Registration is free. In this case we managed the patient by nicotinic acid, statin and L-thyroxin for 2 years. Hypoxia-inducible factors individually facilitate inflammatory myeloid metabolism and inefficient cardiac repair.

Romijn, Theo J. Concomitant medication. Periodic laboratory follow-up including lipid profile and thyroid functions were performed. In addition, treatment strategies are different between patients with CH that is diagnosed during the neonatal period than during early childhood.

Read more about:

Sidebar1?
Sidebar2?