The effects of danazol on a patient with familial dysalbuminemic hyperthyroxinemia.

Katz N, Toney MO, Heironimus JD 2nd
Clinical nuclear medicine · 1993 · doi:10.1097/00003072-199301000-00013 · PMID:8422721
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This case report describes a 35-year-old woman with familial dysalbuminemic hyperthyroxinemia who developed nervousness, insomnia, and weight gain while receiving danazol therapy. Danazol, a synthetic androgen known to decrease thyroid-binding globulin levels, altered the patient's thyroid function tests by increasing triiodothyronine resin uptake while leaving total thyroxine and free thyroxine index levels elevated. Upon discontinuation of the drug, the patient's symptoms resolved and her triiodothyronine resin uptake returned to normal, although thyroid-stimulating hormone remained within normal limits throughout the episode. The authors conclude that ultrasensitive thyroid-stimulating hormone testing is critical for distinguishing this benign condition from true hyperthyroidism in patients taking danazol. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Familial dysalbuminemic hyperthyroxinemia, a syndrome involving an abnormal affinity of albumin for thyroxine, results in elevated total thyroxine and free thyroxine index levels but normal triiodothyronine resin uptake and thyroid-stimulating hormone levels. Danazol is a synthetic androgen that increases triiodothyronine resin uptake and decreases total thyroxine, secondary to a decrease in thyroid-binding globulin levels. A 35-year-old woman with familial dysalbuminemic hyperthyroxinemia who was given danazol, in whom nervousness, insomnia, and weight gain developed, is described. Thyroid tests performed after initiation of danazol therapy revealed an increase in triiodothyronine resin uptake, with persistently elevated total thyroxine and free thyroxine index levels, and normal thyroid-stimulating hormone levels. Once the danazol was withdrawn, the symptoms resolved, the triiodothyronine resin uptake returned to normal, and the thyroid-stimulating hormone remained normal. The effects of danazol on a patient with familial dysalbuminemic hyperthyroxinemia correlate well with the effects on normals, and the ultrasensitive thyroid-stimulating hormone was the most useful test in separating hyperthyroxinemia from hyperthyroidism.
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The Effects of Danazol on a Patient with Familial Dysalbuminemic Hyperthyroxinemia - NEIL KATZ - MORAKINYO O. TONEY - JAMES D. HEIRONIMUS Familial dysalbuminemic hyperthyroxinemia, a syndrome involving an abnormal affinity of albumin for thyroxine, results in elevated total thyroxine and free thyroxine index levels but normal triiodothyronine resin uptake and thyroid-stimulating hormone levels. Danazol is a synthetic androgen that increases triiodothyronine resin uptake and decreases total thyroxine, secondary to a decrease in thyroid-binding globulin levels. A 35-year-old woman with familial dysalbuminemic hyperthyroxinemia who was given danazol, in whom nervousness, insomnia, and weight gain developed, is described. Thyroid tests performed after initiation of danazol therapy revealed an increase in triiodothyronine resin uptake, with persistently elevated total thyroxine and free thyroxine index levels, and normal thyroid-stimulating hormone levels. Once the danazol was withdrawn, the symptoms resolved, the triiodothyronine resin uptake returned to normal, and the thyroid-stimulating hormone remained normal. The effects of danazol on a patient with familial dysalbuminemic hyperthyroxinemia correlate well with the effects on normals, and the ultrasensitive thyroid-stimulating hormone was the most useful test in separating hyperthyroxinemia from hyperthyroidism.

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