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Decreased Expression of Ileal Thyroid Hormone Transporters in a Hypothyroid Patient: A Case Report

BACKGROUND: Malabsorption of levothyroxine (LT4) is a common problem faced in clinical practice. It is usually solved, if there are no complexities including gastrointestinal absorption disorder, by taking medicines on an empty stomach and avoiding foods interfering with LT4. Herein we present a rar...

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Autores principales: Chung, Chae Won, Mo, Eun Young, Jung, Gyung Seo, Kim, Yoo Hyung, Cho, Sun Wook, Park, Do Joon, Bae, Jeong Mo, Park, Young Joo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8187942/
https://www.ncbi.nlm.nih.gov/pubmed/34122338
http://dx.doi.org/10.3389/fendo.2021.664839
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author Chung, Chae Won
Mo, Eun Young
Jung, Gyung Seo
Kim, Yoo Hyung
Cho, Sun Wook
Park, Do Joon
Bae, Jeong Mo
Park, Young Joo
author_facet Chung, Chae Won
Mo, Eun Young
Jung, Gyung Seo
Kim, Yoo Hyung
Cho, Sun Wook
Park, Do Joon
Bae, Jeong Mo
Park, Young Joo
author_sort Chung, Chae Won
collection PubMed
description BACKGROUND: Malabsorption of levothyroxine (LT4) is a common problem faced in clinical practice. It is usually solved, if there are no complexities including gastrointestinal absorption disorder, by taking medicines on an empty stomach and avoiding foods interfering with LT4. Herein we present a rare case of a patient exhibiting malabsorption of LT4 with decreased membranous expression of ileal transporters. CASE: The 22-Year-old female presented with sustained hypothyroid status despite medication of 7.8 μg/kg LT4. Medical history and LT4 absorption test (the absorption rate 8.4%) excluded pseudomalabsorption. No organic gastrointestinal disorder was found in the patient by blood chemistry, endoscopies, and abdominal computed tomography scan. The immunohistochemical analysis showed decreased membranous expression of LAT1 and LAT2 in distal ileum and ascending colon in the patient compared to 20 controls who have no thyroid disease. The expression of MCT8 in colon appeared at both nucleus and brush border in the patient, while it was limited to brush border in controls. The expression of other transporters was similar between the patient and controls. CONCLUSION: The changes of the expression of LAT1 and LAT2 in this patient showing LT4 malabsorption might help to understand the role of intestinal transporters in the absorption of LT4 in humans. The functional relevance of the decrement of LAT1 and LAT2 in this patient remains to be elucidated.
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spelling pubmed-81879422021-06-10 Decreased Expression of Ileal Thyroid Hormone Transporters in a Hypothyroid Patient: A Case Report Chung, Chae Won Mo, Eun Young Jung, Gyung Seo Kim, Yoo Hyung Cho, Sun Wook Park, Do Joon Bae, Jeong Mo Park, Young Joo Front Endocrinol (Lausanne) Endocrinology BACKGROUND: Malabsorption of levothyroxine (LT4) is a common problem faced in clinical practice. It is usually solved, if there are no complexities including gastrointestinal absorption disorder, by taking medicines on an empty stomach and avoiding foods interfering with LT4. Herein we present a rare case of a patient exhibiting malabsorption of LT4 with decreased membranous expression of ileal transporters. CASE: The 22-Year-old female presented with sustained hypothyroid status despite medication of 7.8 μg/kg LT4. Medical history and LT4 absorption test (the absorption rate 8.4%) excluded pseudomalabsorption. No organic gastrointestinal disorder was found in the patient by blood chemistry, endoscopies, and abdominal computed tomography scan. The immunohistochemical analysis showed decreased membranous expression of LAT1 and LAT2 in distal ileum and ascending colon in the patient compared to 20 controls who have no thyroid disease. The expression of MCT8 in colon appeared at both nucleus and brush border in the patient, while it was limited to brush border in controls. The expression of other transporters was similar between the patient and controls. CONCLUSION: The changes of the expression of LAT1 and LAT2 in this patient showing LT4 malabsorption might help to understand the role of intestinal transporters in the absorption of LT4 in humans. The functional relevance of the decrement of LAT1 and LAT2 in this patient remains to be elucidated. Frontiers Media S.A. 2021-05-26 /pmc/articles/PMC8187942/ /pubmed/34122338 http://dx.doi.org/10.3389/fendo.2021.664839 Text en Copyright © 2021 Chung, Mo, Jung, Kim, Cho, Park, Bae and Park https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Chung, Chae Won
Mo, Eun Young
Jung, Gyung Seo
Kim, Yoo Hyung
Cho, Sun Wook
Park, Do Joon
Bae, Jeong Mo
Park, Young Joo
Decreased Expression of Ileal Thyroid Hormone Transporters in a Hypothyroid Patient: A Case Report
title Decreased Expression of Ileal Thyroid Hormone Transporters in a Hypothyroid Patient: A Case Report
title_full Decreased Expression of Ileal Thyroid Hormone Transporters in a Hypothyroid Patient: A Case Report
title_fullStr Decreased Expression of Ileal Thyroid Hormone Transporters in a Hypothyroid Patient: A Case Report
title_full_unstemmed Decreased Expression of Ileal Thyroid Hormone Transporters in a Hypothyroid Patient: A Case Report
title_short Decreased Expression of Ileal Thyroid Hormone Transporters in a Hypothyroid Patient: A Case Report
title_sort decreased expression of ileal thyroid hormone transporters in a hypothyroid patient: a case report
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8187942/
https://www.ncbi.nlm.nih.gov/pubmed/34122338
http://dx.doi.org/10.3389/fendo.2021.664839
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