Thyroid Hormone Resistance due to a Novel De Novo Mutation in Thyroid Hormone Receptor Alpha: First Case Report from the Middle East and North Africa

The physiological actions of thyroid hormone (TH) are mediated through TH alpha and TH beta receptors. Resistance to TH (RTH) is characterized by a lack of peripheral tissues’ response to the active form of TH. TH receptor beta has been extensively studied. Mutations in this receptor were considered...

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Main Authors: Azza Al Shidhani, Irfan Ullah, Hussain AlSaffar, Adila Al Kindi, Hameeda Al Nabhani, Saif Al Yaarubi
Format: Article
Language:English
Published: Oman Medical Specialty Board 2021-01-01
Series:Oman Medical Journal
Subjects:
Online Access:http://omjournal.org/articleDetails.aspx?coType=1&aId=2856
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author Azza Al Shidhani
Irfan Ullah
Hussain AlSaffar
Adila Al Kindi
Hameeda Al Nabhani
Saif Al Yaarubi
author_facet Azza Al Shidhani
Irfan Ullah
Hussain AlSaffar
Adila Al Kindi
Hameeda Al Nabhani
Saif Al Yaarubi
author_sort Azza Al Shidhani
collection DOAJ
description The physiological actions of thyroid hormone (TH) are mediated through TH alpha and TH beta receptors. Resistance to TH (RTH) is characterized by a lack of peripheral tissues’ response to the active form of TH. TH receptor beta has been extensively studied. Mutations in this receptor were considered the main reason for TH resistance for some time up until the discovery of mutations in TH receptor alpha (TRα) that has attained more focus and interest in recent years. A 13-year-old child with classic hypothyroidism features (coarse facies, growth and developmental delay, skeletal dysplasia, generalized muscular hypertrophy, and severe constipation) associated with near-normal thyroid hormone levels, which did not support the diagnosis of hypothyroidism biochemically. Therefore, progressing with whole-exome sequencing had revealed a de novo heterozygous mutation in a gene encoding TRα that establishes a diagnosis of RTHα. This case report demonstrates a rare form of TH resistance due to mutation of TRα. It also emphasizes that THs act through distinctive receptor subtypes in different target tissues. Moreover, this report aims to raise awareness about this genetic mutation, which is thought to be more common than expected. However, due to its subtle features and insidious presentation, many cases remain undiagnosed; hence, the disorder’s exact incidence is unknown.
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spelling doaj.art-53bdf68838664514bf873da0eed59f3f2022-12-21T19:39:20ZengOman Medical Specialty BoardOman Medical Journal1999-768X2070-52042021-01-01361e226e22610.5001/omj.2021.20Thyroid Hormone Resistance due to a Novel De Novo Mutation in Thyroid Hormone Receptor Alpha: First Case Report from the Middle East and North AfricaAzza Al Shidhani0Irfan Ullah1Hussain AlSaffar2Adila Al Kindi3Hameeda Al Nabhani4Saif Al Yaarubi5Child Health Department, Sultan Qaboos University Hospital, Muscat, OmanChild Health Department, Sultan Qaboos University Hospital, Muscat, OmanChild Health Department, Sultan Qaboos University Hospital, Muscat, OmanGenetic Department, Sultan Qaboos University Hospital, Muscat, OmanPediatric Department, Nizwa Hospital, Nizwa, Muscat, OmanChild Health Department, Sultan Qaboos University Hospital, Muscat, OmanThe physiological actions of thyroid hormone (TH) are mediated through TH alpha and TH beta receptors. Resistance to TH (RTH) is characterized by a lack of peripheral tissues’ response to the active form of TH. TH receptor beta has been extensively studied. Mutations in this receptor were considered the main reason for TH resistance for some time up until the discovery of mutations in TH receptor alpha (TRα) that has attained more focus and interest in recent years. A 13-year-old child with classic hypothyroidism features (coarse facies, growth and developmental delay, skeletal dysplasia, generalized muscular hypertrophy, and severe constipation) associated with near-normal thyroid hormone levels, which did not support the diagnosis of hypothyroidism biochemically. Therefore, progressing with whole-exome sequencing had revealed a de novo heterozygous mutation in a gene encoding TRα that establishes a diagnosis of RTHα. This case report demonstrates a rare form of TH resistance due to mutation of TRα. It also emphasizes that THs act through distinctive receptor subtypes in different target tissues. Moreover, this report aims to raise awareness about this genetic mutation, which is thought to be more common than expected. However, due to its subtle features and insidious presentation, many cases remain undiagnosed; hence, the disorder’s exact incidence is unknown.http://omjournal.org/articleDetails.aspx?coType=1&aId=2856thyroid hormone resistance syndromereceptorsthyroid hormonewhole exome sequencingmutation
spellingShingle Azza Al Shidhani
Irfan Ullah
Hussain AlSaffar
Adila Al Kindi
Hameeda Al Nabhani
Saif Al Yaarubi
Thyroid Hormone Resistance due to a Novel De Novo Mutation in Thyroid Hormone Receptor Alpha: First Case Report from the Middle East and North Africa
Oman Medical Journal
thyroid hormone resistance syndrome
receptors
thyroid hormone
whole exome sequencing
mutation
title Thyroid Hormone Resistance due to a Novel De Novo Mutation in Thyroid Hormone Receptor Alpha: First Case Report from the Middle East and North Africa
title_full Thyroid Hormone Resistance due to a Novel De Novo Mutation in Thyroid Hormone Receptor Alpha: First Case Report from the Middle East and North Africa
title_fullStr Thyroid Hormone Resistance due to a Novel De Novo Mutation in Thyroid Hormone Receptor Alpha: First Case Report from the Middle East and North Africa
title_full_unstemmed Thyroid Hormone Resistance due to a Novel De Novo Mutation in Thyroid Hormone Receptor Alpha: First Case Report from the Middle East and North Africa
title_short Thyroid Hormone Resistance due to a Novel De Novo Mutation in Thyroid Hormone Receptor Alpha: First Case Report from the Middle East and North Africa
title_sort thyroid hormone resistance due to a novel de novo mutation in thyroid hormone receptor alpha first case report from the middle east and north africa
topic thyroid hormone resistance syndrome
receptors
thyroid hormone
whole exome sequencing
mutation
url http://omjournal.org/articleDetails.aspx?coType=1&aId=2856
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