Diiodothyropropionic acid (DITPA) in the treatment of MCT8 deficiency

二碘甲状腺丙酸 (DITPA) 治疗 MCT8 缺乏症

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作者:Charles F Verge, Daniel Konrad, Michal Cohen, Caterina Di Cosmo, Alexandra M Dumitrescu, Teresa Marcinkowski, Shihab Hameed, Jill Hamilton, Roy E Weiss, Samuel Refetoff

Conclusion

DITPA (1-2 mg/kg · d) almost completely normalizes thyroid tests and reduces the hypermetabolism and the tendency for weight loss. The effects of earlier commencement and long-term therapy remain to be determined.

Methods

This was a multicenter report of four affected children given DITPA on compassionate grounds for 26-40 months. Treatment was initiated at ages 8.5-25 months, beginning with a small dose of 1.8 mg, increasing to a maximal 30 mg/d (2.1-2.4 mg/kg · d), given in three divided doses.

Objective

The objective of the study was to evaluate the effect and efficacy of DITPA in children with MCT8 deficiency.

Results

DITPA normalized the elevated serum T(3) and TSH when the dose reached 1 mg/kg · d and T(4) and rT(3) increased to the lower normal range. The following significant changes were also observed: decline in SHBG (in all subjects), heart rate (in three of four), and ferritin (in one of four). Cholesterol increased in two subjects. There was no weight loss and weight gain occurred in two. None of the treated children required a gastric feeding tube or developed seizures. No adverse effects were observed.

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