バセドウ病多発家系における甲状線機能正常者のT3抑制試験とTRHテスト

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An investigation was made using 97 clinically and chemically euthyroid relatives (T3-RSU, serum T3, T4 and TSH; normal) in whom there were more than 2 thyrotoxic patients within the two degree relationship. The TRH test was performed in all 97 cases. In 56 of the 97 cases the T3 suppression test was also performed just after each TRH test. The results revealed that 29 of the 97 cases (29.9%) showed an abnormal response to TRH. Fourteen of these (14.4%) revealed a negative or a hyporesponse (peak value of TSH was less than 4.9 μU/ml), and 15 cases (15.5%) revealed a hyperresponse (peak value of TSH was more than 35 μU/ml) to TRH. For the T3 suppression test, 4 of 56 cases (7.1%) were nonsuppressible. Seven individuals who showed negative or hyporesponse to TRH consisted of two nonsuppressible subjects and five suppressible subjects. In 14 no or hyporesponsive cases, serum T3 (1.51±0.05 ng/ml) and T4 (9.91±0.31 μg/dl) were significantly higher compared with those of normal responders (1.30±0.04 ng/ml), (8.57±0.21 μg/dl) or hyperresponders (1.16±0.06 ng/ml), (7.77±0.63 big/dl). There was no definite correlation between negative or hyporesponders and nonsuppressible cases. The following results were obtained : 1) In 29 of the 97 cases (29.9%), TRH tests showed abnormal response. Fourteen of these (14.4%) revealed a no or hyporesponse. 2) In the no or hyporesponsive cases, serum T3 and T4 were significantly higher compared with those of normal responders or hyperresponders. 3) Six of the 69 cases (8.7%) showed above 40% of the 24-hr thyroidal 131I-UPT. 4) For the T3 suppression test, 4 of the 56 cases (7.1%) were nonsuppressible, and in the nonsuppressible cases, serum T3 was significantly higher than that of suppressible cases. 5) We found a high occurrence of thyroglobulin and microsomal antibodies in our studies suggesting a linkage with hereditary predisposition.
日本内分泌学会の論文

バセドウ病多発家系における甲状線機能正常者のT<SUB>3</SUB>抑制試験とTRHテスト

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