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Thyroid hormone metabolism, abnormal, 3(THMA3)

MedGen UID:
1824065
Concept ID:
C5774292
Disease or Syndrome
Synonym: THMA3
 
Gene (location): TRU-TCA1-1 (19q13.32)
 
Monarch Initiative: MONDO:0859354
OMIM®: 620198

Definition

Abnormal thyroid hormone metabolism-3 (THMA3) is characterized by euthyroid hyperthyroxinemia, with elevated free T4 and reverse T3 levels, and normal TSH (see 188540) and free T3 levels. Patients also show low plasma selenium levels and reduced levels of stress-related selenoproteins (Schoenmakers et al., 2016; Geslot et al., 2021). For a discussion of genetic heterogeneity of abnormal thyroid hormone metabolism, see THMA1 (609698). [from OMIM]

Clinical features

From HPO
Abdominal pain
MedGen UID:
7803
Concept ID:
C0000737
Sign or Symptom
An unpleasant sensation characterized by physical discomfort (such as pricking, throbbing, or aching) and perceived to originate in the abdomen.
Easy fatigability
MedGen UID:
373253
Concept ID:
C1837098
Finding
Increased susceptibility to fatigue.
Muscle weakness
MedGen UID:
57735
Concept ID:
C0151786
Finding
Reduced strength of muscles.
Decreased circulating selenium concentration
MedGen UID:
1756605
Concept ID:
C5421674
Finding
An abnormally reduced concentration of selenium in the blood circulation.
Euthyroid hyperthyroxinemia
MedGen UID:
867191
Concept ID:
C4021549
Disease or Syndrome
Increased levels of thyroxine without evidence of clinical thyroid disease.
Increased circulating free T3
MedGen UID:
867466
Concept ID:
C4021843
Finding
An elevated concentration of free 3,3',5-triiodo-L-thyronine in the blood circulation.
Abnormal thyroid-stimulating hormone level
MedGen UID:
1384219
Concept ID:
C4476968
Finding
Any deviation from the normal amount of the thyroid-stimulating hormone (TSH), which is produced by the anterior pituitary gland and stimulates the function of the thyroid gland.
Abnormal circulating free T3 concentration
MedGen UID:
1689152
Concept ID:
C5139194
Finding
A deviation from the normal concentration of free triiodothyronine (T3) in the blood circulation. A proportion of T3 is bound to plasma proteins in the blood, including mainly thyroxine binding globulin, transthyretin, and albumin. T3 that is not bound to a protein is referred to as free T3.
Abnormal circulating free T4 concentration
MedGen UID:
1732628
Concept ID:
C5421590
Finding
A deviation from the normal concentration of free thyroxine (T4) in the blood circulation. Circulating T4 is almost entirely bound to specific transport proteins such as thyroxine-binding globulin (TBG) but it is the unbound (free) fraction that is able to enter tissues and exert effects.
Increased circulating free T4 concentration
MedGen UID:
1771990
Concept ID:
C5421591
Finding
An elevated concentration of free thyroxine (fT4) in the blood circulation.
Elevated circulating reverse T3 concentration
MedGen UID:
1815050
Concept ID:
C5706144
Finding
Abnormally increased concentration of reverse T3 (3,3',5'-triiodothyronine or rT3) in the blood circulation.

Professional guidelines

PubMed

Biondi B
Heart Fail Clin 2019 Jul;15(3):393-398. Epub 2019 Apr 5 doi: 10.1016/j.hfc.2019.02.008. PMID: 31079697

Recent clinical studies

Etiology

Biondi B
Heart Fail Clin 2019 Jul;15(3):393-398. Epub 2019 Apr 5 doi: 10.1016/j.hfc.2019.02.008. PMID: 31079697
Bai MF, Gao CY, Yang CK, Wang XP, Liu J, Qi DT, Zhang Y, Hao PY, Li MW
J Cardiol 2014 Dec;64(6):496-500. Epub 2014 Jun 17 doi: 10.1016/j.jjcc.2014.03.009. PMID: 24951271

Therapy

Biondi B
Heart Fail Clin 2019 Jul;15(3):393-398. Epub 2019 Apr 5 doi: 10.1016/j.hfc.2019.02.008. PMID: 31079697

Prognosis

Biondi B
Heart Fail Clin 2019 Jul;15(3):393-398. Epub 2019 Apr 5 doi: 10.1016/j.hfc.2019.02.008. PMID: 31079697
Bai MF, Gao CY, Yang CK, Wang XP, Liu J, Qi DT, Zhang Y, Hao PY, Li MW
J Cardiol 2014 Dec;64(6):496-500. Epub 2014 Jun 17 doi: 10.1016/j.jjcc.2014.03.009. PMID: 24951271

Clinical prediction guides

Bai MF, Gao CY, Yang CK, Wang XP, Liu J, Qi DT, Zhang Y, Hao PY, Li MW
J Cardiol 2014 Dec;64(6):496-500. Epub 2014 Jun 17 doi: 10.1016/j.jjcc.2014.03.009. PMID: 24951271

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