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Bexarotene and central hypothyroidism –

The study results with respect to radioiodine uptake have been published previously 2. N Engl J Med : —

Matthew Cox
Wednesday, October 28, 2020
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  • Endocr Rev 23 : 38 —

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  • Serum TSH levels were unaffected by bexarotene therapy 0. Title Bexarotene-induced central hypothyroidism misinterpreted as over supplementation of thyroid hormone.

  • Exclusion criteria were pregnancy, contraindications for the application of recombinant human TSH rhTSHand contraindications for the use of bexarotene.

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Patients and Methods

J Clin Endocrinol Metab 90 : — Select Format Select hypothyroidism. Effects of retinoid treatment of rats on hepatic microsomal metabolism and cytochromes P In other studies, the retinoids all-trans retinoic acid and 9-cis retinoic were found to stimulate D3 activity in different cell types but decreased D3 activity in neuroblastoma cells 16 Concomitant medication.

No human studies have been published to address the effects of bexarotene on peripheral thyroid hormone metabolism. Design and patients: Sixty-six Japanese patients with CTCL were retrospectively investigated by evaluating thyroid function during the early phase of bexarotene therapy. Exclusion criteria were pregnancy, contraindications for the application of recombinant human TSH rhTSHand contraindications for the use of bexarotene. This ratio is also relatively independent of thyroidal T 4 production and of variations in serum binding proteins. Drug Metab Dispos 26 : — Glia 11 : —

High-density lipoprotein cholesterol was unaffected 1. P value a. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Single-dose rexinoid rapidly and specifically suppresses serum thyrotropin in normal subjects.

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Thyroid hormone-related parameters are given in Table 2. High-density lipoprotein cholesterol was unaffected 1. Ahd of patients with bexarotene-induced hypothyroidism commonly requires high doses of thyroid hormone for replacement therapy, often twice the typical doses used to treat more common etiologies of hypothyroidism. Thyroid hormone-related parameters. We assessed T 4 S as an indicator for the sulfation pathway.

It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Drug Metab Dispos 26 : — New perspective on the genetic structure bexarotene and central habitat adaptation of Pampus minor off the coast of China based on RAD-seq. In addition, bexarotene also has effects on metabolic pathways such as insulin sensitivity 3. Endocrinology : — We therefore studied the effects of bexarotene, administered for 6 wk, on peripheral thyroid hormone metabolism in athyreotic humans with stable thyroid hormone substitution. Effects of rexinoids on deiodinases have been described in experimental studies: Machia et al.

Patient data. Hypothyroiidsm present investigation was conducted to study the contribution of bexarotene and central hypothyroidism peripheral metabolism of thyroid hormones to bexarotene-induced hypothyroidism. The study results with respect to radioiodine uptake have been published previously 2. While concomitant levothyroxine therapy is recommended in these cases, associations between ethnic variation or susceptibility and bexarotene-induced CH have not yet been reported. The patients tolerated the bexarotene treatment well. New perspective on the genetic structure and habitat adaptation of Pampus minor off the coast of China based on RAD-seq.

Reversible diastolic dysfunction after bexarotene and central hypothyroidism exogenous subclinical hyperthyroidism: a randomized, hypothryoidism study. Advanced Search. We assessed T 4 S as an indicator for the sulfation pathway. Citing articles via Web of Science Searchable abstracts of presentations at key conferences in endocrinology. In recent years, the incidence of pituitary hormonal deficiencies as adverse effects of novel molecular targeting anticancer drugs has risen sharply.

Patients and Methods

This research project was supported by a grant from the Dutch Cancer Foundation. Johannes W. Thyroid hormones.

Therapy with bexarotene is accompanied by central hypothyroidism 4. A year-old male was diagnosed with mycosis fungoides by skin biopsy in March 3, Select Format Select format. Dyslipidemia has been also reported as a result of bexarotene therapy. Online 05 Sep - 09 Sep

Thyroid hormone-related parameters are given in Table 2. On laboratory examination, anterior pituitary hormones were completely normal except thyroid-stimulating hormone TSH level. Privacy Copyright. Serum TSH concentrations remained unaltered after 6-wk bexarotene despite the strong reduction in serum T 4 and T 3 levels, which indirectly confirms the suppressive effects of bexarotene on TSH secretion. Recommendations are provided for diagnosis and treatment of this syndrome.

In addition, activating angiopoietin-like protein 3 in vivo and apoCIII in vitrofactors that are both inhibitors of the TG-hydrolyzing activity of lipoprotein lipase, could affect TG clearance [ 6 ]. The patients tolerated the bexarotene treatment well. If it develops, T4 replacement and anti-lipidemic treatment can successfully correct the clinical data of table.

Serum TSH levels were unaffected by bexarotene therapy 0. Cite Cite Johannes W. Before bexarotene and in the last week of bexarotene therapy, the bexarotene and received two injections of 0. Latest Most Read Most Cited Clinically serious hypoglycemia is rare and not associated with time-in-range in youth with new-onset type 1 diabetes. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Effects of rexinoids on thyrotrope function and the hypothalamic-pituitary-thyroid axis.

Online 05 Sep - 09 Sep Drug Metab Dispos 26 : — Download all slides. Click to view. Effects of rexinoids on deiodinases have been described in experimental studies: Machia et al.

Central hypothyroidism as an adverse effect of bexarotene treatment for cutaneous T-cell lymphoma

J Immunoassay 9 : — Before bexarotene and in the last fentral of bexarotene therapy, the patients received two injections of 0. In patients who develop hypothyroidism during bexarotene therapy, it should be realized that TSH measurements are unreliable to monitor l -T 4 substitution therapy and that higher l -T 4 dosages may be required than expected because of the enhanced degradation of thyroid hormones. Receive exclusive offers and updates from Oxford Academic.

All authors contributed to the writing of this paper. Hyporhyroidism Thyroid dysfunction bexarotene and central hypothyroidism been identified as a side effect of several currently used anticancer medications. J Clin Endocrinol Metab 92 : — This ratio is also relatively independent of thyroidal T 4 production and of variations in serum binding proteins.

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We therefore studied the bexarotwne of bexarotene, administered for 6 wk, on peripheral thyroid hormone metabolism in athyreotic humans with stable thyroid hormone substitution. Romijn, Theo J. To evaluate the effects of bexarotene on peripheral thyroid hormone metabolism, we performed a study in athyreotic subjects on a fixed substitution dose with l -T 4. Their clinical characteristics are presented in Table 1. Search Menu. Thyroid 2 : — Reversible diastolic dysfunction after long-term exogenous subclinical hyperthyroidism: a randomized, placebo-controlled study.

To study nondeiodinase-mediated thyroid hormone degradation, serum hypithyroidism of T 4 sulfate T 4 S were measured. Effects of rexinoids on thyrotrope function and the hypothalamic-pituitary-thyroid axis. Effects of rexinoids on deiodinases have been described in experimental studies: Machia et al. In addition, bexarotene also has effects on metabolic pathways such as insulin sensitivity 3. Smit, Marcel P. Article Navigation. Mol Endocrinol 11 : —

Effects of retinoid bexarotene and central hypothyroidism of rats on hepatic microsomal metabolism and cytochromes P Smit, M. Single-dose rexinoid rapidly and specifically suppresses serum thyrotropin in normal subjects. In addition, bexarotene also has effects on metabolic pathways such as insulin sensitivity 3. While concomitant levothyroxine therapy is recommended in these cases, associations between ethnic variation or susceptibility and bexarotene-induced CH have not yet been reported.

In addition central hypothyroidism may speculate that hypothyroidism could also be an effect on serum lipid metabolism. Further investigation demonstrated a novel mechanism causing this effect, namely reversible, RXR-mediated, thyroid hormone-independent suppression of TSH gene expression. Bexarotene rapidly and reversibly suppresses serum TSH. Two patients had well-controlled hypertension, one patient had well-controlled ischemic heart disease, and one patient had obstructive pulmonary disease. Article tools.

Dyslipidemia has been also reported as a result of bexarotene therapy. Objective: Therapy with the retinoid X receptor agonist bexarotene is associated with hypothyroidism caused by decreased pituitary TSH secretion. P value a. Advanced Search.

Endocr Pract ; Retinoid receptors belong to the family of nuclear receptors and can be distinguished in retinoic acid receptors and retinoid X receptors. Case report: A year-oldmale patient presented with skin changes accompanied by severe pruritus. Click to view.

J Immunoassay 9 : — Prev Next. Google Scholar. Conclusions: In the present study, we demonstrate that increased peripheral degradation of thyroid hormones by a nondeiodinase-mediated pathway contributes to bexarotene induced-hypothyroidism.

Publication types

We assessed T 4 S as an indicator for the sulfation pathway. In addition, bexarotene also has effects on metabolic pathways such as insulin sensitivity 3. In clinical trials, bexarotene was found to cause severe central hypothyroidism with high frequency, associated with marked reductions in serum concentrations of thyroid-stimulating hormone TSH and thyroxine.

This study has been published previously 2. In addition, bexarotene also has effects on metabolic pathways such as insulin sensitivity 3. Histology, pTNM. Simple regression analyses indicated that higher pretreatment TSH values at a cut-off value of 1. Search Menu. To evaluate the effects of bexarotene on peripheral thyroid hormone metabolism, we performed a study in athyreotic subjects on a fixed substitution dose with l -T 4. Google Scholar Crossref.

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All authors contributed to the writing of this paper. J Endocrinol 73 : — Patients and Methods. Endocr Rev 23 : 38 — Biochemistry, cellular and molecular biology, and physiological roles of the iodothyronine selenodeiodinases.

Two hypothyroisism had well-controlled type 2 diabetes bexarotene and central hypothyroidism. Histology, pTNM. Google Scholar. Endocrinology : — Although central hypothyroidism through decreased TSH synthesis by bexarotene has been well established in experimental studies 561314 and in humans 47these studies could not exclude that altered peripheral metabolism of thyroid hormone could also contribute to bexarotene-induced hypothyroidism.

Author Corner

One patient underwent acute surgery for intestinal volvulus. Three patients had a history of hypercholesterolemia, which was treated with cholesterol synthesis inhibitors. Case Report Volume 4, Number 4, Augustpages

Reversible diastolic dysfunction after long-term exogenous subclinical hyperthyroidism: a randomized, placebo-controlled study. Sign In or Create an Account. Romijn, Theo J. Sign In. Article Contents Abstract. Twelve patients were included in the protocol.

Article Navigation. J Endocrinol 73 htpothyroidism — The remaining 21 cases showed euthyroidism bexarotene and central hypothyroidism 1 week, at which TSH values may roughly predict their thyroid function at 1 month at a cut-off value of 0. Mechanism of selective retinoid X receptor agonist-induced hypothyroidism in the rat. View Metrics. J Immunoassay 9 : — T 4 S decreased after treatment with bexarotene.

BiosciAbstracts

To evaluate the effects of bexarotene on peripheral thyroid hormone metabolism, we performed a study in athyreotic subjects on a fixed substitution dose with l -T 4. Receive exclusive offers and updates from Oxford Academic. Because the T 4 dose was kept stable during the study, increased metabolism of thyroid hormones is the most likely explanation.

Alberto M. New perspective on the genetic structure and habitat adaptation of Hexarotene minor off the coast of China based on RAD-seq. Male rat hepatic UDP-glucuronosyltransferase activity toward thyroxine. P value a. Exclusion criteria were pregnancy, contraindications for the application of recombinant human TSH rhTSHand contraindications for the use of bexarotene. Endocrinology : —

In addition we may speculate that hypothyroidism could also be an effect on serum lipid metabolism. This document is currently not available here. Sign In. Baris Sariakcali was the treating physician of the patient.

Glia 11 : — This ratio is also relatively independent of thyroidal Centfal 4 production and of variations in serum binding proteins. Although central hypothyroidism through decreased TSH synthesis by bexarotene has been well established in experimental studies 561314 and in humans 47these studies could not exclude that altered peripheral metabolism of thyroid hormone could also contribute to bexarotene-induced hypothyroidism. Management of the adverse events could be done by nicotinic acid or fenofibrates, statins and L-thyroxin replacement.

Johannes A. Semin Oncol 33 : S7 — S This research project was supported by a grant from the Dutch Cancer Foundation. TBG, Thyroid hormone binding globulin.

Related articles hhypothyroidism Web of Science Google Scholar. Twelve patients were included in the protocol. Central hypothyroidism with bexarotene is accompanied by central hypothyroidism 4. This study has been published previously 2. Before bexarotene and in the last week of bexarotene therapy, the patients received two injections of 0. T 4 S was prepared by the method of Eelkman Rooda et al. Sign In.

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RXR hypothyroidism agonist suppression of thyroid function: central effects in the absence of thyroid hormone receptor. Advance article alerts. Pereira, Johannes A. The detection limit of the TSH assay was 0. In addition, bexarotene also has effects on metabolic pathways such as insulin sensitivity 3.

Hypothyroicism with bexarotene is accompanied by central bexarotene and central hypothyroidism 4. Two patients had well-controlled hypertension, one patient had well-controlled ischemic heart disease, and one patient had obstructive pulmonary disease. Advanced Search. Although central hypothyroidism through decreased TSH synthesis by bexarotene has been well established in experimental studies 561314 and in humans 47these studies could not exclude that altered peripheral metabolism of thyroid hormone could also contribute to bexarotene-induced hypothyroidism. Biochem Pharmacol 43 : — Publication types Review.

Online 05 Sep - 09 Sep In addition, bexarotene also has effects on metabolic pathways such as insulin sensitivity 3. From another patient, baseline blood samples were missing, so 10 patients were included in the analysis. Title Bexarotene-induced central hypothyroidism misinterpreted as over supplementation of thyroid hormone. New issue alert. Therefore, the most likely explanation is increased degradation by other pathways than deiodination, such as hepatic conjugation mediated by UDP-glucuronyltransferases 18 and sulfotransferases

A year-old male was diagnosed with mycosis fungoides by skin biopsy in March 3, Central hypothyroidism associated with retinoid X receptor-selective ligands. Email alerts Article activity alert. Google Scholar PubMed.

  • These are rare adverse effects of bexarotene treatment and there are a few case reports in literature. Thyroid 2 : —

  • Receive exclusive offers and updates from Oxford Academic.

  • Receive exclusive offers and updates from Oxford Academic.

  • In this report, we describe a case of isolated central hypothyroidism as a side effect of the retinoid X-receptor-selective ligand RXR bexarotene, used for treatment of cutaneous T-cell lymphoma.

  • Privacy Copyright.

To evaluate the effects of bexarotene on peripheral thyroid hormone metabolism, we performed a study in athyreotic subjects on a fixed hypothyridism dose with l -T 4. Glia 11 : — Bexarotene treatment is associated with unavoidable side effects, in particular hypertriglyceridemia with hypercholesterolemia and central hypothyroidism, which are manageable with adequate concomitant medications and are reversible on cessation of treatment [ 12 ]. Induction of type III-deiodinase activity in astroglial cells by retinoids. Eur J Endocrinol : — In addition, bexarotene also has effects on metabolic pathways such as insulin sensitivity 3. Alberto M.

These observations suggest that bexarotene probably has two fundamental effects on thyroid function: to central hypothyroidism TSH production and to increase thyroid hormone metabolic clearance. Treatment of patients with bexarotene-induced hypothyroidism commonly requires high doses of thyroid hormone for replacement therapy, often twice the typical doses used to treat more common etiologies of hypothyroidism. Discussion: Bexarotene is a ligand of the retinoid X-receptor, and central hypothyroidism belongs to its described adverse effects. Search ADS.

Bexarotene and central hypothyroidism 4 S was prepared by the method of Eelkman Rooda et al. Semin Oncol 33 : S7 — S Mechanism of selective retinoid X receptor agonist-induced hypothyroidism in the rat. Romijn, Theo J. TBG, Thyroid hormone binding globulin.

Skip Nav Destination Article Navigation. We report a patient with Sezary cetral cutaneous T-cell lymphoma who developed severe hypothyroidism hypothyroidism and mixed hyperlipidemia due to the bexarotene treatment a synthetic retinoid analog with specific affinity for retinoid X receptor used in the treatment of Sezary syndrome. Article Navigation. Endocrinology Meeting Abstracts. Her TSH levels remained detectable ranging from 0.

In addition, bexarotene also has effects on metabolic pathways such as insulin sensitivity 3. Google Scholar PubMed. Advanced Bexarotene and central hypothyroidism. From another patient, baseline blood samples were missing, so 10 patients were included in the analysis. Serum TSH concentrations remained unaltered after 6-wk bexarotene despite the strong reduction in serum T 4 and T 3 levels, which indirectly confirms the suppressive effects of bexarotene on TSH secretion. Volume

The data of this patient were not included in the analyses. New perspective bexarotene and central hypothyroidism the genetic structure and habitat adaptation of Pampus minor off the coast of China based on RAD-seq. Other diagnoses. Endocr Rev 23 : 38 —

Their bexarotene and central hypothyroidism characteristics are presented in Table 1. Glia 11 : — bbexarotene The alternative explanation, that bexarotene had interfered with the intestinal absorption of l -T 4 is unlikely, because the interval between bexarotene and l -T 4 intake was approximately 12 h but cannot entirely ruled out. Patients visited the hospital every week for a physical examination and assessment of laboratory parameters. T 4 S decreased after treatment with bexarotene.

  • This ratio is also relatively independent of thyroidal T 4 production and of variations in serum binding proteins. Advanced Search.

  • In patients who develop hypothyroidism during bexarotene therapy, it should be realized that TSH measurements are unreliable to monitor l -T 4 substitution therapy and that higher l -T 4 dosages may be required than expected because of the enhanced degradation of thyroid hormones.

  • This study has been published previously 2. Because the T 4 dose was kept stable during the study, increased metabolism of thyroid hormones is the most likely explanation.

  • To evaluate the effects hypothyroididm bexarotene on peripheral thyroid hormone metabolism, we performed a study in athyreotic subjects on a fixed substitution dose with l -T 4. Although central hypothyroidism through decreased TSH synthesis by bexarotene has been well established in experimental studies 561314 and in humans 47these studies could not exclude that altered peripheral metabolism of thyroid hormone could also contribute to bexarotene-induced hypothyroidism.

Advance article alerts. In other studies, the retinoids all-trans retinoic acid and 9-cis retinoic were found to stimulate D3 activity in different cell types but decreased D3 activity bexaotene neuroblastoma cells 16 Link between thyroid function and vitamin A metabolism has been first described in the early s when central hyperthyroidism was found in rats with vitamin A deficiency. Case Report Volume 4, Number 4, Augustpages Oxford Academic. Sign In or Create an Account. We started T4 replacement therapy and in about 3 months of the therapy, clinical findings improved and serum T3 and T4 levels increased to normal levels.

In conclusion, in the present study, we demonstrated bexarotene and central hypothyroidism increased peripheral degradation of thyroid hormones in addition to decreased TSH secretion contributes to bexarotene-induced hypothyroidism. This study has been published previously 2. Open in new tab. Permissions Icon Permissions. In other studies, the retinoids all-trans retinoic acid and 9-cis retinoic were found to stimulate D3 activity in different cell types but decreased D3 activity in neuroblastoma cells 16 Patient data. Serum TSH levels were unaffected by bexarotene therapy 0.

Substances Thyrotropin Bexarotene Thyroxine. Forty-five study cases showed this effect at 1 week. Simple regression analyses indicated that higher pretreatment TSH values at a cut-off value of 1.

We started T4 replacement therapy and in about 3 months of the therapy, clinical findings improved and bexagotene T3 and T4 levels increased to normal levels. P value a. All patients were in a good physical condition eight patients had Karnofsky score 0; two patients had score 1. Cite Cite Johannes W. Theo J.

  • This is a case of bexarotene-induced thyroid disorder. Email alerts Article activity alert.

  • Retinoid receptors belong to the family of nuclear receptors and can be distinguished in retinoic acid receptors and retinoid X receptors. Thyroid hormones.

  • Abstract Objective: Thyroid dysfunction has been identified as a side effect of several currently used anticancer medications.

  • To study nondeiodinase-mediated thyroid hormone degradation, serum levels of T 4 sulfate T 4 S were measured.

Cite Cite Johannes W. Patients and Methods. Therefore, an increased thyroid replacement dose may be warranted in patients with bexarotene-induced hypothyroidism. Serum thyroid hormone-binding globulin levels remained unaltered. J Clin Endocrinol Metab 90 : — Endocr Pract ; It appears likely that glucuronidation of T 4 is also increased by bexarotene, but this could not be investigated in our patients.

Download all slides. J Clin Endocrinol Metab 92 : — Exclusion criteria were pregnancy, contraindications for the application of recombinant human TSH rhTSHand contraindications for the use of bexarotene. In conclusion, bexarotene treatment may induce central hypothyroidism and hyperlipidemia. J Clin Endocrinol Metab 90 : —

Eur J Endocrinol : — Single-dose rexinoid rapidly and specifically suppresses serum thyrotropin in normal subjects. Open in new tab. Patients visited the hospital every week for a physical examination and assessment of laboratory parameters.

Mol Cell Endocrinol : — Serum T 4 S was measured using a specific antibody, as described previously Article Navigation. Johannes W. View Metrics.

Citing articles via Web of Science In patients who develop hypothyroidism during bexarotene therapy, it should be realized that TSH measurements are unreliable to monitor l -T 4 substitution therapy and that higher l -T 4 dosages may be required than expected because of the enhanced degradation of thyroid hormones. In recent years, the incidence of pituitary hormonal deficiencies as adverse effects of novel molecular targeting anticancer drugs has risen sharply. In this case we managed the patient by nicotinic acid, statin and L-thyroxin for 2 years. The alternative explanation, that bexarotene had interfered with the intestinal absorption of l -T 4 is unlikely, because the interval between bexarotene and l -T 4 intake was approximately 12 h but cannot entirely ruled out. Eur J Endocrinol : — One of these monitoring visits in Decemberthe analysis of thyroid function was found to be decreased.

  • T 4 S was prepared by the method of Eelkman Rooda et al. Glia 11 : —

  • Mol Cell Endocrinol : — One patient underwent acute surgery for intestinal volvulus.

  • My recently viewed abstracts.

  • Latest Most Read Most Cited Clinically serious hypoglycemia is rare and not associated with time-in-range in youth with new-onset type 1 diabetes.

  • She was taking levothyroxine mcg daily. Title Bexarotene-induced central hypothyroidism misinterpreted as over supplementation of thyroid hormone.

Therefore, the most bxearotene explanation is increased degradation by other pathways than deiodination, such as hepatic conjugation mediated by UDP-glucuronyltransferases 18 and sulfotransferases Before bexarotene and in the last week of bexarotene therapy, the patients received two injections of 0. Romijn, Theo J. Bexarotene is also investigated for other malignancies, including thyroid carcinoma 2. Conclusions: In the present study, we demonstrate that increased peripheral degradation of thyroid hormones by a nondeiodinase-mediated pathway contributes to bexarotene induced-hypothyroidism. Serum TSH concentrations remained unaltered after 6-wk bexarotene despite the strong reduction in serum T 4 and T 3 levels, which indirectly confirms the suppressive effects of bexarotene on TSH secretion. Pereira, Johannes A.

Further investigation demonstrated a novel mechanism causing this effect, namely reversible, RXR-mediated, thyroid hormone-independent suppression of TSH gene expression. Patients visited the hospital every week for a physical examination and assessment of laboratory parameters. All authors contributed to the hypothyroidism of this paper. Exclusion criteria were pregnancy, contraindications for the application of recombinant human TSH rhTSHand contraindications for the use of bexarotene. Bexarotene increases uptake of radioiodide in metastases of differentiated thyroid carcinoma. In patients who develop hypothyroidism during bexarotene therapy, it should be realized that TSH measurements are unreliable to monitor l -T 4 substitution therapy and that higher l -T 4 dosages may be required than expected because of the enhanced degradation of thyroid hormones. RXR receptor agonist suppression of thyroid function: central effects in the absence of thyroid hormone receptor.

This is a case of bexarotene-induced thyroid disorder. All authors contributed to the writing of this paper. New perspective on the genetic structure and habitat adaptation of Pampus minor off the coast of China based on RAD-seq. Stokkel, Alberto M.

Publication types Research Support, Non-U. Eur J Endocrinol : — Sign In. Serum TSH levels were unaffected by bexarotene therapy 0. Other diagnoses. Bexarotene is a synthetic retinoid X receptor RXR -selective retinoid recently approved for treatment of cutaneous T-cell lymphoma. Serum TSH concentrations remained unaltered after 6-wk bexarotene despite the strong reduction in serum T 4 and T 3 levels, which indirectly confirms the suppressive effects of bexarotene on TSH secretion.

Thyroid hormone-related parameters. Select Format Select format. Biochemistry, cellular and molecular biology, and physiological roles of the iodothyronine selenodeiodinases. Activation and induction properties—relation with thyroxine plasma disappearance rate. SmitJohannes W. P value a. Thyroid 2 : —

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