Serum levels of FSH and TSH in nonfunctioning pituitary adenomas before and after surgery

Clinically nonfunctioning human pituitary adenomas [NFPAs] constitute about 25-35% of pituitary tumours. Relatively few studies have been carried out to determine the cellular origin and biology of the NFPAs. The present study was undertaken to assess the effect of' surgical removal of adenoma on peripheral adenohypophyseal hormones. In addition, the pituitary hormones have also been measured directly in the adenoma tissue following its surgical removal. The present study is based on 19 patients [16 males and 3 females], 30-50 year of age, diagnosed for NFPAs on the basis of clinical and radiological evidence. Follicle stimulating hormone [FSH] and thyroid stimulating hormone [TSH] were determined in serum before and following transsphenoidal adenomectomy. The FSH, TSH content of the excised adenoma tissue was also measured in male patients. The results demonstrate that in a subset of 4 of the 16 male patients with NFPAs the presurgical serum FSH values [45.1 +/- 0.7 mIU/ml] were markedly and significantly greater than those of the remaining 12 patients [7.9 +/- 0.7 mIU/ml] and of control subjects [8.8 +/- 0.6 mIU/ml]. Following removal of the adenoma in these 4 patients, peripheral serum FSH levels fell within the normal range. In the remaining 12 patients peripheral and mean FSH levels were within the normal range. Following removal of the adenoma in 2 female patients, serum FSH concentrations showed a marked decline of FSH levels [5.7 mIU/ml and 7.2 mIU/ ml] whereas in the remaining one patient, the FSH levels remained relatively high [34.5 mIU/ ml]. The adenoma tissue FSH content in patients with initial higher serum FSH levels, was also significantly greater than that of the other patients [21.5 +/- 2.1 vs 4.4 +/- 1.9 IU/g]. The presurgical mean serum TSH concentrations in patients with NFPA were mostly in the lower normal range and were not significantly different from the control [1.0 +/- 0.2 vs 1.5 +/- 0.4 micro IU/ml] and removal of the adenoma did not affect the serum TSH levels significantly. The TSH content of adenoma tissue was either non-detectable or in the low range as compared to the TSH content determined in control pooled pituitary tissue. The present study suggests that pituitary tumours diagnosed as NFPAs constitute a heterogenous group of adenomas with regard to their secretory activity of intact adenohypophyseal hormones. Whereas some of these adenomas activity may synthesize one or more pituitary hormones, peripheral concentrations may not be sufficient to produce overt clinical symptoms of hormone hypersecretion

Serum levels of unconjugated estriol during normal pregnancy in Pakistani women

Using a specific radiofmrnunoassay, serum levels of unconjugated oestriol were measured in 27 normal women during the 16th to the 36th week of pregnancy. The data obtained show a rise In the mean oestriol level which increased from 1.15 +/- 0.23 ng/ ml In the 16-week to 16,36 +/- 3.6 ng ml in the 36-week. During 16-24 weeks of pregnancy, mean serum oestriol levels ranged between 1.15 and 2.08 ng ml. A marked rase In oestriol concentrations [7.1 +/- 1,5 ng/ml] was observed at 28 weeks. In subsequent months the serum oestriol concentration increased steadily reaching the mean value of 16.36 +/- 3.6 ng ml, near term, In one patient, receiving antibiotic treatment, the levels remained low until the 32nd week of pregnancy. In five subjects including a Rh negative individual, the serum oestrici levels were within the normal range until 28 weeks of pregnancy but there was a marked fall in the levels during the 32nd week. In these subjects, however, the foetal outcome was normal In one case a neonatal death occurred following delivery in which the serum oestnoi concentration was normal. Except for an earlier rise in the serum oestriol concentration, the profile of oestriol levels during pregnancy in this restricted sample of Pakistan women, indicated no major divergence from the already reported data