Hormone-resistance syndromes can be broadly defined as conditions resulting from reduced or absent end-organ responsiveness to biologically active hormones. They are caused by defects in hormone receptors or post-receptor defects.
1-3 Mutations in the thyroid hormone–receptor β gene cause resistance to thyroid hormone, which is characterized by elevated serum thyroid hormone concentrations with few or no clinical and biochemical manifestations of thyroid hormone excess and, most notably, normal or slightly increased thyrotropin secretion.
1 Mutations that inactivate the thyrotropin receptor or the G (guanine nucleotide–binding) protein that couples the receptor to adenylate cyclase should cause thyrotropin resistance, resulting in either hypothyroidism or euthyroidism with increased thyrotropin secretion, depending on the completeness of the defect. There have been several reports of patients with congenital hypothyroidism,
4-6 including some with familial hypothyroidism,
7 and an apparent resistance to the action of thyrotropin. However, sequencing of the thyrotropin and thyrotropin-receptor genes in these patients revealed no abnormalities.
8