Resistance to thyroid hormone due to a mutation in thyroid hormone receptor beta
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Summary
Resistance to thyroid hormone due to a mutation in thyroid hormone receptor beta (MONDO:0700478) is a disease with 1 cohort gene.
At a glance
- Prevalence: Unknown (United States) [Orphanet-validated]
- Cohort genes: 1
- ClinVar variants: 1
- Phenotypes (HPO): 20
Clinical features
Epidemiology
Prevalence records
2 prevalence record(s), Orphanet:
| Type | Class | Value | Geography | Validation |
|---|---|---|---|---|
| Prevalence at birth | 1-9 / 100 000 | 2.47 | United States | Validated |
| Prevalence at birth | 1-9 / 100 000 | 2.4 | Japan | Validated |
Signs & symptoms
Clinical features (HPO)
20 HPO clinical features (Orphanet curated; top 20 by frequency):
| HPO ID | Term | Frequency |
|---|---|---|
| HP:0000853 | Goiter | Very frequent (80-99%) |
| HP:0001649 | Tachycardia | Very frequent (80-99%) |
| HP:0033075 | Inappropriately normal thyroid-stimulating hormone level | Very frequent (80-99%) |
| HP:0033077 | Increased circulating free T4 concentration | Very frequent (80-99%) |
| HP:0000403 | Recurrent otitis media | Frequent (30-79%) |
| HP:0000739 | Anxiety | Frequent (30-79%) |
| HP:0000752 | Hyperactivity | Frequent (30-79%) |
| HP:0001328 | Specific learning disability | Frequent (30-79%) |
| HP:0002750 | Delayed skeletal maturation | Frequent (30-79%) |
| HP:0007018 | Attention deficit hyperactivity disorder | Frequent (30-79%) |
| HP:0011788 | Increased circulating free T3 | Frequent (30-79%) |
| HP:0025379 | Anti-thyroid peroxidase antibody positivity | Frequent (30-79%) |
| HP:0032069 | Anti-thyroglobulin antibody positivity | Frequent (30-79%) |
| HP:0034288 | Elevated circulating reverse T3 concentration | Frequent (30-79%) |
| HP:0000407 | Sensorineural hearing impairment | Occasional (5-29%) |
| HP:0001530 | Mild postnatal growth retardation | Occasional (5-29%) |
| HP:0001962 | Palpitations | Occasional (5-29%) |
| HP:0012758 | Neurodevelopmental delay | Occasional (5-29%) |
| HP:0025484 | Increased circulating thyroglobulin concentration | Occasional (5-29%) |
| HP:0031098 | Decreased thyroid-stimulating hormone level | Excluded (0%) |
Identifiers
Disease identifiers
| Field | Value |
|---|---|
| Canonical name | resistance to thyroid hormone due to a mutation in thyroid hormone receptor beta |
| Mondo ID | MONDO:0700478 |
| Orphanet | 566243 |
| GARD | 0028049 |
| Is cancer (heuristic) | no |
Data availability: 1 ClinVar variant.
Disease family
An umbrella term covering 3 Mondo subtypes.
Classification path: disease › human disease › disease by body system or component › endocrine system disorder › thyroid gland disorder › inherited thyroid metabolism disease › thyroid hormone resistance syndrome › resistance to thyroid hormone due to a mutation in thyroid hormone receptor beta
Related subtypes (3): generalized resistance to thyroid hormone, selective peripheral resistance to thyroid hormone, resistance to thyroid hormone due to a mutation in thyroid hormone receptor alpha
Subtypes (3): selective pituitary resistance to thyroid hormone, thyroid hormone resistance, generalized, autosomal dominant, thyroid hormone resistance, generalized, autosomal recessive
Genetics & variants
GWAS landscape
No GWAS associations recorded — common-variant (GWAS) studies don’t cover this disease (typical for Mendelian / rare diseases). See the curated gene cohort and Mendelian overlap below.
Variant details and genetic-evidence tiers
ClinVar germline variants
1 retrieved; paginated sample, class counts are floors:
1 pathogenic/likely pathogenic
| ClinVar | Variant (HGVS) | Gene | Classification | Review |
|---|---|---|---|---|
| 492926 | NM_001354712.2(THRB):c.1378G>A (p.Glu460Lys) | THRB | Pathogenic/Likely pathogenic | criteria provided, multiple submitters, no conflicts |
Genes & proteins
Mendelian disease overlap and somatic drivers
GenCC: 0 · Orphanet: 1 · OMIM-shared: 0 · Dual-evidence (GWAS+Mendelian): 0
Orphanet rare-disease linkage (cohort genes)
| Gene | Orphanet ID | Rare disease |
|---|---|---|
| THRB | Orphanet:566243 | Resistance to thyroid hormone due to a mutation in thyroid hormone receptor beta |
Cohort genes → proteins
1 cohort genes, 1 distinct canonical proteins.
Evidence partition
| Subset | Genes |
|---|---|
| multi_evidence | 1 |
Cohort genes (full)
| Symbol | HGNC | Ensembl | UniProt | Name | Evidence |
|---|---|---|---|---|---|
| THRB | HGNC:11799 | ENSG00000151090 | P10828 | Thyroid hormone receptor beta | clinvar |
Cohort function summary
Lead sentence per gene, UniProt-curated.
| Symbol | Protein name | Function (lead sentence) |
|---|---|---|
| THRB | Thyroid hormone receptor beta | Nuclear hormone receptor that can act as a repressor or activator of transcription. |
Protein-family classification
Druggable: 1 · Difficult: 0 · Unknown: 0 · Druggable fraction: 1.0
Family distribution
Cohort families vs a genome-wide background (hypergeometric, BH-FDR; fold = observed/expected). Counts kept; sorted by enrichment, so the catch-all Other/Unknown bucket no longer leads.
| Family | Genes | Fold | FDR |
|---|---|---|---|
| Nuclear receptor | 1 | 385.9× | 0.003 |
Per-gene assignment
| Symbol | Family | Druggable? | EC | InterPro (top 3) |
|---|---|---|---|---|
| THRB | Nuclear receptor | yes | Nucl_hrmn_rcpt_lig-bd, Znf_hrmn_rcpt, Nuclear_hrmn_rcpt |
Expression context
Cohort genes with no expression data: 0.
1 cohort gene are a single-cell marker in ≥1 SCXA experiment.
Breadth distribution (Bgee present_calls)
| Bucket | Genes |
|---|---|
| narrow (1-5 tissues) | 0 |
| moderate (6-20) | 0 |
| broad (>20) | 1 |
| unknown | 0 |
Top tissues across cohort
| Tissue | Cohort genes |
|---|---|
| Brodmann (1909) area 23 | 1 |
| middle temporal gyrus | 1 |
| tibia | 1 |
Per-gene tissue summary (top 30)
| Symbol | Bgee breadth | FANTOM5 breadth | SCXA | Top tissues |
|---|---|---|---|---|
| THRB | 267 | ubiquitous | marker | Brodmann (1909) area 23, middle temporal gyrus, tibia |
Protein interactions among cohort
Intra-cohort edges: 0.
Hub genes (top 10 by interactor count)
| Symbol | Interactor count |
|---|---|
| THRB | 2,044 |
Structural data
PDB: 1 · AlphaFold-only: 0 · No structure: 0
Cohort genes with PDB structures (top 30)
| Symbol | UniProt | PDB entries |
|---|---|---|
| THRB | P10828 | 34 |
Function
Pathway analysis
Distinct Reactome pathways touched by cohort: 9. Enrichment computed across 1 evidence-associated genes (1 with Reactome annotation).
Pathways by enrichment
Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 1 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.
| Pathway | Cohort genes | Fold | FDR | Sample cohort genes |
|---|---|---|---|---|
| SUMOylation of intracellular receptors | 1 | 335.9× | 0.014 | THRB |
| Nuclear Receptor transcription pathway | 1 | 200.3× | 0.014 | THRB |
| SUMO E3 ligases SUMOylate target proteins | 1 | 178.4× | 0.014 | THRB |
| SUMOylation | 1 | 163.1× | 0.014 | THRB |
| RNA Polymerase II Transcription | 1 | 22.5× | 0.072 | THRB |
| Post-translational protein modification | 1 | 19.2× | 0.072 | THRB |
| Gene expression (Transcription) | 1 | 17.8× | 0.072 | THRB |
| Generic Transcription Pathway | 1 | 15.1× | 0.074 | THRB |
| Metabolism of proteins | 1 | 12.4× | 0.081 | THRB |
GO biological processes by enrichment
Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 1 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.
| GO term | Cohort genes | Fold | FDR | Sample cohort genes |
|---|---|---|---|---|
| female courtship behavior | 1 | 5617.3× | 9e-04 | THRB |
| retinal cone cell apoptotic process | 1 | 5617.3× | 9e-04 | THRB |
| thyroid hormone receptor signaling pathway | 1 | 4213.0× | 9e-04 | THRB |
| positive regulation of thyroid hormone receptor signaling pathway | 1 | 4213.0× | 9e-04 | THRB |
| negative regulation of female receptivity | 1 | 3370.4× | 9e-04 | THRB |
| type I pneumocyte differentiation | 1 | 1532.0× | 0.001 | THRB |
| cellular response to thyroid hormone stimulus | 1 | 1532.0× | 0.001 | THRB |
| retinal cone cell development | 1 | 1404.3× | 0.001 | THRB |
| retinoic acid receptor signaling pathway | 1 | 648.1× | 0.003 | THRB |
| regulation of heart contraction | 1 | 495.6× | 0.003 | THRB |
| mRNA transcription by RNA polymerase II | 1 | 330.4× | 0.004 | THRB |
| DNA-templated transcription | 1 | 224.7× | 0.006 | THRB |
| sensory perception of sound | 1 | 100.9× | 0.012 | THRB |
| cell differentiation | 1 | 29.1× | 0.039 | THRB |
| negative regulation of transcription by RNA polymerase II | 1 | 17.7× | 0.060 | THRB |
| positive regulation of transcription by RNA polymerase II | 1 | 14.9× | 0.067 | THRB |
Therapeutics
Drug target analysis
Approved (phase 4): 1 · Phase ≥3: 1 · Phased (≥1): 1 · Undrugged: 0
Druggability breadth: 1 of 1 evidence-associated genes (100%) have a ChEMBL target (buckets above are over the deeply-mined display cohort).
Genes with an approved drug
The molecule shown is one approved compound that hits the gene — not necessarily a drug of choice or one indicated for this disease.
| Symbol | Example approved molecule |
|---|---|
| THRB | AMINOCAPROIC ACID |
Top cohort targets by molecule count
| Symbol | Molecules | Max phase |
|---|---|---|
| THRB | 117 | 4 |
Drugs targeting cohort genes (top 30)
| Molecule | Max phase | Targets in cohort |
|---|---|---|
| AMINOCAPROIC ACID | 4 | THRB |
| INDIGOTINDISULFONATE | 4 | THRB |
| CHLORMADINONE ACETATE | 4 | THRB |
| AMOXAPINE | 4 | THRB |
| IDARUBICIN | 4 | THRB |
| DYCLONINE HYDROCHLORIDE | 4 | THRB |
| ISOSORBIDE | 4 | THRB |
| CLOMIPRAMINE HYDROCHLORIDE | 4 | THRB |
| CHLORMEZANONE | 4 | THRB |
| PHENOXYBENZAMINE HYDROCHLORIDE | 4 | THRB |
| METHYSERGIDE MALEATE | 4 | THRB |
| LIOTHYRONINE SODIUM | 4 | THRB |
| DYCLONINE | 4 | THRB |
| ROSE BENGAL FREE ACID | 4 | THRB |
| INAMRINONE | 4 | THRB |
| MOLSIDOMINE | 4 | THRB |
| METRONIDAZOLE | 4 | THRB |
| AMILORIDE HYDROCHLORIDE | 4 | THRB |
| ALTRETAMINE | 4 | THRB |
| BISOPROLOL FUMARATE | 4 | THRB |
| ATORVASTATIN | 4 | THRB |
| OXYTETRACYCLINE | 4 | THRB |
| LIOTHYRONINE | 4 | THRB |
| MECLOFENAMATE SODIUM | 4 | THRB |
| DAUNORUBICIN HYDROCHLORIDE | 4 | THRB |
| AMANTADINE HYDROCHLORIDE | 4 | THRB |
| ACETOHEXAMIDE | 4 | THRB |
| DEBRISOQUIN SULFATE | 4 | THRB |
| PHENYTOIN SODIUM | 4 | THRB |
| LEVOTHYROXINE | 4 | THRB |
Bioactivity and enzyme data
Enzyme cohort genes (≥1 EC): 0.
Cohort genes with ChEMBL bioactivity (full, sorted by assay count)
| Symbol | Assays | Type breakdown |
|---|---|---|
| THRB | 169 | Binding:129, Functional:40 |
Cohort genes with high screening signal
≥100 ChEMBL assays — a studied-ness signal; see Therapeutics for approved-drug status.
| Symbol | ChEMBL assays |
|---|---|
| THRB | 169 |
Pharmacogenomics
Cohort genes with a PharmGKB record: 1; with CPIC/DPWG dosing guidelines: 0.
No cohort gene has a CPIC/DPWG genotype-guided dosing guideline (PharmGKB).
Chemical tractability of cohort targets
30 approved/phased compounds have measured bioactivity against a cohort gene (and aren’t yet in disease-level trials). This is a research / tractability signal, NOT a therapeutic recommendation — a bioactivity row often reflects off-target or screening binding (e.g. promiscuous kinase inhibitors against a cohort kinase), implying no disease mechanism.
| Compound | Max phase | Cohort target (bioactivity) |
|---|---|---|
| AMINOCAPROIC ACID | 4 | THRB |
| INDIGOTINDISULFONATE | 4 | THRB |
| CHLORMADINONE ACETATE | 4 | THRB |
| AMOXAPINE | 4 | THRB |
| IDARUBICIN | 4 | THRB |
| DYCLONINE HYDROCHLORIDE | 4 | THRB |
| ISOSORBIDE | 4 | THRB |
| CLOMIPRAMINE HYDROCHLORIDE | 4 | THRB |
| CHLORMEZANONE | 4 | THRB |
| PHENOXYBENZAMINE HYDROCHLORIDE | 4 | THRB |
| METHYSERGIDE MALEATE | 4 | THRB |
| LIOTHYRONINE SODIUM | 4 | THRB |
| DYCLONINE | 4 | THRB |
| ROSE BENGAL FREE ACID | 4 | THRB |
| INAMRINONE | 4 | THRB |
| MOLSIDOMINE | 4 | THRB |
| METRONIDAZOLE | 4 | THRB |
| AMILORIDE HYDROCHLORIDE | 4 | THRB |
| ALTRETAMINE | 4 | THRB |
| BISOPROLOL FUMARATE | 4 | THRB |
| ATORVASTATIN | 4 | THRB |
| OXYTETRACYCLINE | 4 | THRB |
| LIOTHYRONINE | 4 | THRB |
| MECLOFENAMATE SODIUM | 4 | THRB |
| DAUNORUBICIN HYDROCHLORIDE | 4 | THRB |
| AMANTADINE HYDROCHLORIDE | 4 | THRB |
| ACETOHEXAMIDE | 4 | THRB |
| DEBRISOQUIN SULFATE | 4 | THRB |
| PHENYTOIN SODIUM | 4 | THRB |
| LEVOTHYROXINE | 4 | THRB |
Druggability pyramid
Cohort genes binned by druggability tier (high → low):
| Tier | Definition | Genes | Symbols |
|---|---|---|---|
| A | Approved (phase 4 drug) | 1 | THRB |
| B | Phased (≥1) drug, not yet approved | 0 | |
| C | Druggable family + PDB, no drug | 0 | |
| D | Druggable family + AlphaFold only, no drug | 0 | |
| E | Difficult family or no structure, no drug | 0 |
Undrugged target profiles
0 cohort genes are undrugged. Ranked by ‘starting-point quality’ (assay depth + drugged-partner adjacency).
Clinical trials & evidence
Clinical trials
Clinical trials: 0.
Related Atlas pages
- Cohort genes: THRB