[TSH-secreting adenoma: Difficulty in management and review of literature-about one case]

TSH-secreting adenomas are rare; they represent less than 2 or 3% of all pituitary adenomas. We report a case of TSH-secreting adenoma in a 52 year old man revealed by cardiac arrythmia. The diagnosis was made in presence of hyperthyroidism with a TSH in the upper limit of normal value, with an increase in the alpha sub-unit and with the presence on the MRI of a pituitary macroadenoma. The patient was treated with somatostatin analogues before transphenoidal surgery. TSH-secreting adenomas are classically revealed by hyperthyroidisni with inappropriate secretion of TSH and a pituitary adenoma. Transphenoidal surgery is the recommended treatment but the results are not always satisfactory because most adenomas are invasive macroadenomas. Somatostatin analogues improve management and prognosis of these adenomas

[Congenital hypothyroidism: about 5 observations]

Congenital hypothyroidism is one of the most frequent endocrine disease in childhood and its consequences are potentially harmful on the neurological and intellectual development of the child. We report the following 5 cases to underline the rarity of certain aetiologies and importance of an early management. Our first case involves a brother and a sister coming from Ouezzane [endemic zone], who presented at the age of 20 with an enormous goitre and cretinism. The second case is about two brothers and one sister coming from Sale [a non endemic area], with consanguineous parents. The first case was discovered at birth because of a neonatal goiter. The diagnosis in the second and third siblings was made when they were around 2 years of age because of a goitre and signs of hypothyroidism. Hormonal substitution was prescribed with a good physical and psychomotor evolution. If iodine deficiency remains the most frequent aetiology, other causes such as hormonogenesis disorders must be considered in non endemic area. In our countiy, systematic screening for congenital hypothyroidism during the neonate period, as well as an early treatment will make it possible to improve the physical and psychomotor prognosis of congenital hypothyroidism