A Case of Total Thyroxine-Binding Globulin Deficiency with Graves' Disease: Fluctuations of Plasma Triiodothyronine/Thyroxine Ratio

A 37-year-old male with total thyroxine-binding globulin (TBG) deficiency associated with Graves' disease is described. Both TBG immunoreactivity and TBG capacity were not detectable in his serum. Serum concentrations of thyroxine-binding prealbumin and albumin were normal. He was initally hype...

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Bibliographic Details
Published inJapanese Journal of Medicine Vol. 25; no. 2; pp. 186 - 190
Main Authors KAMIKUBO, Keita, KOJIMA, Noriko, YAMAKITA, Noriyoshi, MIURA, Kiyoshi
Format Journal Article
LanguageEnglish
Published Japan The Japanese Society of Internal Medicine 01.05.1986
Subjects
Adult
Graves Disease - blood
Graves' disease
Hormonal conversion
Hormonal kinetics
Hormonal metabolism
Humans
Hyperthyroidism
Hyperthyroidism - blood
Hypothyroidism
Hypothyroidism - blood
Male
Methimazole - pharmacology
TBG deficiency
Thyroid hormone
Thyroid Hormones - metabolism
Thyroxine
Thyroxine - blood
Thyroxine-Binding Proteins - deficiency
Triiodothyronine
Triiodothyronine - blood
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Summary:A 37-year-old male with total thyroxine-binding globulin (TBG) deficiency associated with Graves' disease is described. Both TBG immunoreactivity and TBG capacity were not detectable in his serum. Serum concentrations of thyroxine-binding prealbumin and albumin were normal. He was initally hyperthyroid. During methimazole-treatment he was maintained in an euthyroid state except for two short hypothyroid periods. His plasma triiodothyronine/thyroxine (T3/T4) ratios during both the untreated hyperthyroid and the methimazole-induced hypothyroid states were higher than those during his methimazole-induced euthyroid state. These findings on changes in his T3/T4 ratio accompanying thyroidal dysfunction were qualitatively comparable with those in patients with Graves' disease with normal TBG levels: that both untreated hyperthyroid and methimazole-induced hypothyroid patients showed higher T3/T4 ratios than methimazole-induced euthyroid patients. These results may provide indirect evidence that changes in hormonal secretion and conversion that raise T3/T4 ratio can occur in thyroidal dysfunctions even in the complete absence of TBG.
Bibliography:ObjectType-Case Study-2
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ISSN:0021-5120
1881-123X
DOI:10.2169/internalmedicine1962.25.186