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Thyroxin binding globulin deficiency – a case study and literature review.


Authors: A. Kreze jr. 1;  M. Pura 2;  M. Kosák 1;  J. Koskuba 1
Authors‘ workplace: II . Interní oddělení Fakultní nemocnice Bulovka, Praha Primář: MUDr. Jiří Koskuba. 1;  Národný endokrinologický a diabetologický ústav, Ľubochňa Primár: MUDr. Peter Vaňuga, Ph. D. 2
Published in: Prakt. Lék. 2008; 88(7): 425-426
Category: Case Report

Overview

Abnormalities in the serum proteins that transport thyroid hormones do not alter the metabolic state and do not cause thyroid disease. However, they do alter total thyroid hormone concentrations in serum and, when unrecognized, may lead to inappropriate treatment. Therefore, estimation of TSH and fT4 concentrations is usually all that is required for evaluation of thyroid function. Measurement of TBG and total hormones is only appropriate for special targets, and is not common practice.

Key words:
total thyroxine, free thyroxine, TBG, deficiency TBG.


Sources

1. Beierwaltes, W.H., Robbins, J. Familial increase in the thyroxine–binding sites in serum alpha globulin. J. Clin. Incest. 1959, 38, p. 1683–1688.

2. Fleming, J.J., Rajaratnam, S., Seshadri M.S. et al. An audit of total and free thyroxine measurement in screening for hypo and hyperthyroidism in patients using chemiluminiscence immunoassay. Ind. J. Clin. Bioch. 2001, 16, p. 95-100.

3. Gharib, H., Tuttle, R.M., Baskin H.J. et al. Subclinical thyroid dysfunction: a joint statement on management from the American association of clinical endocrinologist, the American thyroid association, and the Endocrine society. JCEM 2005, 1, p. 581-585.

4. Hayashi, Y., Refetoff, S. Genetic abnormalities of thyroid hormone transport serum proteins. In: Weintraub, B. Molecular endocrinology. Basic concepts and clinical correlations. New York: Raven Press, 1995, p. 371–387.

5. Helfand, M. Screening for subclinical thyroid dysfunction in non pregnent adults. Summary and evidence. Ann. Intern. Med. 2004, 140, p. 128-141.

6. Larsen, P.R., Davies, T.F., Schlumberger, M.J. et al. Thyroid physiology and diagnostic evaluation of patients with thyroid disorders. In: Larsen, P.R., Kronenberg, H.M., Melmed, S., Polonsky K.S. Williams textbook of endocrinology. Philadelphia: Saunders, 2003. 1927 p.

7. Mori, Y., Miura, Y., Oiso, Y. et al. Precise localisation of the human thyroxine–binding globulin gene to chromozome Xq22.2 by flouroscence in situ hybridization. Hum. Genet. 1995, 96, p. 481-482.

8. Refetoff, S., Dumont, J.E., Vassart, G. Thyroid disorders. In: Scriver, C.R., Beaudet, A.L., Sly, W.S., Valle, D., Childs, B., Vogelstein, B. The metabolic and molecular basis of inherited disease (8 ed.). New York: McGraw-Hill, 2000. 4029–4075 p.

9. Sarlis, N.J., Hirshberg, B. Thyroxin-binding globulin deficiency [on line]. Dostupný na www.emedicine.com/med/topic2277.htm. Updated 12. 6. 2006. [cit. 2008-05-06].

10. Singer, P.A. Evaluation of thyroid function. In: Lavin, N.: Manual of endocrinology and metabolism. Philadelphia: Lippincott Williams Wilkins, 2002. 854 p.

11. Surks, M.I. Primary hypotyroidism. New issues and controversies. Endocrinologist 2006, 16, p. 203–207.

12. Trent, J.M., Flink, I.L., Morkin, E. et al. Localization of the human thyroxine-binding globuline gene to the long arm of the X chromozome(Xq21-22). Am. J. Hum. Genet. 1987, 41, p. 428–435.

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