REFRACTORINESS TO THYROID HORMONE IN HYPOTHYROID PATIENTS

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Abstract
A description of a 34-year old patient was given who 2 months after a postpartum hemorrhage and 1 month after the onset of acute meningo-encephalitic episodes developed a hypothalamic syndrome associated with hypothyroid manifestations. A primary hypothalamic origin of the syndrome as the result of the meningoencephalitic condition was assumed. The patient did not respond to comparatively large amounts of desiccated thyroid (0.3 g a day) continually given for about 2 years. After excessive doses (0.8 g a day for 10 days) a state of euthyroidism was achieved. After this the previously ineffective dose of 0.3 g a day proved sufficient to maintain the patient in an euthyroid state for more than 2 years. When, however, thyroid was abruptly withdrawn at the end of that period, the patient remained euthyroid for the following 5.5 months. The hypothalamic manifestations remained unaffected by treatment during the whole period of observation but were subject to spontaneous fluctuations.