In 15-year-old girl with diffuse thyroid enlargement and clinical symptoms of hyperthyroidism total T4 levels and T3 resin uptake were in the range of normal, TSH however was undetectable and total T3 with 5, 6 ng/ml was significantly elevated. TRH and T3 suppression tests indicated an autonomous thyroid function. Thyroid stimulating immunoglobulins examined by radioreceptor method gave higly positive results. The diagnosis was: T3 toxicosis in a patient with Graves' disease. At the age of 15 ? she started with metizol/methyl-2-mercaptoimidazole/ therapy and after 17 days thyreoidea sicca was added. Serum T4 decreased gradually during 2 months to hypothyroidal levels /6, 8-1, 8-0, 0 /ug/100 ml/but T3, was still elevated /5, 6-2, 2-3, 5 ng/ml respectively/.These observations allow to suppose an excessive peripheral T4 to T3 conversion in our patient.
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机译：在15岁的甲状腺弥漫性甲状腺肿大和甲状腺功能亢进症的临床症状的女孩中，总T4水平和T3树脂摄入量处于正常范围内，但是TSH却无法检测到，总T3（5、6 ng / ml）显着升高。 TRH和T3抑制试验表明甲状腺功能自主。通过放射受体法检查的刺激甲状腺的免疫球蛋白获得了积极的阳性结果。诊断为：Graves病患者的T3中毒。 15岁？她开始使用metizol / methyl-2-mercaptoimidazole /疗法，并在17天后加入了thyreoidea sicca。血清T4在2个月内逐渐降低至甲状腺功能减退水平/ 6、8-1、8-0、0 / ug / 100 ml / ml，但T3仍分别升高至/ 5、6-2、2-3、5 ng / ml /。这些观察结果假设我们的患者外周血T4过度转化为T3。
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