The TSH receptor is formed as one polypeptide chain and inserted into the thyroid cell plasma membrane. It undergoes a processing that is reminiscent of that occurring with insulin. A segment of 30 or more amino acids is cut out of the receptor at approximately residue 320, forming a two peptide structure with the chains held together by disulfide bonds. It is thought that both the intact and the processed receptor are functional. The processing of the receptor is thought to involve a matrix metalloprotease-like enzyme cleaving the 120 kDa precursor to form the heterodimeric receptor. Subsequently, reduction of the disulfide bonds by a protein disulfide isomerase may separate the two molecules and lead to shedding of the “alpha” subunit. It is an interesting concept that shedding of the alpha subunit might be intimately related to onset of autoimmunity against the TSH receptor. Shedding of the receptor is augmented by TSH stimulation of thyroid cells (58). The amino-terminal ectodomain of the human TSH receptor has been expressed on the surface of CHO cells as a glycosylphosphatidylinositol-anchored molecule. This material can be released from the cells and is biologically active in that it binds immunoglobulins from serum of patients with Graves’ disease, and displays saturable binding of TSH (46), indicating that all of the “immunologic information” related to production of antibodies resides in the extracellular portion of TSH-R.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.
That is a horrible experience and I know it all too well. Mine may have been less severe than yours, but it was probably the most painful thing I have EVER experienced. Last October, I was in the hospital & I was kinda freaking out a little, so they involuntarily gave me Haldol to relieve some of my anxiety. Mind you, I was 5 months pregnant at this time. I’ve taken it b4 & had issues, but never this severe. If I take benadryl or cogentin w/it, I’m usually fine. It all started w/ a stiff neck & then back. Then my face began to tighten & i had involuntary spasms of the face. My neck was so tight that I experienced the same thing as you… my neck was turned completely sideways & trying to go toward the back of my shoulder as well. They did not want to give me either cogentin or benadryl b/c of the pregnancy. It progreased very quickly & I was crying in agony. They thought I was faking it up until they finally gave me some cogentin thru my IV & I had complete relief in less than 5-10 minutes. However, my muscles in my neck & back were very fatigued after that. I never want to go thru that EVER again & I now list haldol as an allergy on all my medical records.