0100488969

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CLINICAL OBSERVATIONS ON THERAPEUTIC APPLICATIONS OF THYROTROPIN-RELEASING HORMONE (TRH)

English (英語)

The Kobe journal of the medical sciences

20(2)

65-81

1974-06

An attempt was made to evaluate the possibility of therapeutic use of TRH in cases of hypothyrotropic hypothyroidism with special reference to its effects on pituitary-thyroid function. Firstly, changes in plasma TSH, serum T4, serum PBI and T3 RSU were observed in healthy volunteers who were treated with single or repeated oral administration of TRH. Plasma TSH increase was obtained from 2 to 4 hours after the single oral administration of 4, 5 and 10 mg of TRH. Serum T 4 and PBI levels also rose 6-8 hours after single oral administration in doses of 3 mg and more. As to repeated administration, TRH was administered orally by 2 to 8 times in doses of 2, 4 and 6 mg, and observation continued 2 to 4 days. Almost all cases showed plasma TSH increase at 2 to 4 hours after each oral administration of TRH. Serum T4, PBI and Ta RSU also increased at 6 to 8 hours after each TRH administration. However, there was individual variation of TRH induced TSH increase and thyroid hormone response. Moreover, TRH administration was performed to 3 patients with hypothyroidism due to craniopharyngioma, ectopic pinealoma and suspected hypopituitarism. Both cases of craniopharyngioma and ectopic pinealoma showed sufficient pituitary TSH reserve to TRH test, in which plasma TSH, rising from low basal level, reached the normal range. Thus both cases may be postulated as belonging to the category of the so called hypothalamic hypothyroidism. The case of suspected hypopituitarism who has subclinical hypothyroidism, showed almost normal TSH increase to TRH test. Four mg of TRH was administered daily to these 3 patients for 3 weeks or more. Gradual increases of serum T4, T3 and PBI were obtained and these increases reached their peaks 2 weeks after the onset of the oral administration. Although one case showed the decrease of blood thyroid hormone concentration after the withdrawal of TRH administration, another case showed a continued high level of serum T4, the level being within normal range even 2 and 6 weeks after the withdrawal. Further studies on therapeutic application of TRH would be significant for the development of replacement therapy on hypothyrotropic hypothyroidism.

hypothyroidism

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