A Case of Growth Hormone (GH) Deficient Adult with Tertiary Hypothyroidism who Showed Signs of Hyperthyroidism During GH Treatment

摘要

An adult patient with growth hormone deficiency (GHD) who showed signs of hyperthyroidism during growth hormone (GH) treatment.The patient was a 58-year-old male who contracted GHD, tertiary hypothyroidism, and hypogonadotropic hypogonadism and received levo-thyroxine (1-T4) (150μg/day) and testosterone enantate replacement therapy (125mg/2weeks, i. m.). Three months after the GH treatment was started, he began to notice increased perspiration and decreased body weight. Just before he noticed these signs, his serum triiodothyronine (T3) was 2.6ng/ml and T3/T4 ratio was 0.22; we therefore made the diagnosis of hyperthyroidism. After we reduced the 1-T4, these signs disappeared.Although there are some reports about the effects of GH administration on thyroid function, there is no report of hyperthyroidism in a GH deficient patient during GH therapy. It is well known that peripheral conversion of T4 to T3 is increased by GH. But it is possible that the appearance of hypothyroidism or hyperthyroidism during GH treatment is caused by differences in the basal thyroid function or in the dosage of replacement therapy.