Thyroid hormone inactivation in gastrointestinal stromal tumors.
case_report · Level V
Where this comes from
- Record sourced from PubMed, PMID 24693892.
- Also identified by DOI 10.1056/NEJMoa1308893 and PMC identifier 4186889.
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Abstract
Gastrointestinal stromal tumors (GISTs) are resistant to traditional chemotherapy but are responsive to the tyrosine kinase inhibitors imatinib and sunitinib. The use of these agents has improved the outcome for patients but is associated with adverse effects, including hypothyroidism. Multiple mechanisms of this effect have been proposed, including decreased iodine organification and glandular capillary regression. Here we report the finding of consumptive hypothyroidism caused by marked overexpression of the thyroid hormone-inactivating enzyme type 3 iodothyronine deiodinase (D3) within the tumor. Affected patients warrant increased monitoring and may require supernormal thyroid hormone supplementation.
Medical subject headings
- Gastrointestinal Neoplasms
- Gastrointestinal Stromal Tumors
- Hypothyroidism
- Iodide Peroxidase
- Thyroid Hormones