A case of Van Wyk-Grumbach syndrome: clinical analysis / 中华全科医师杂志

The clinical data of a child with Van Wyk-Grumbach syndrome (VWGS) who visited Capital Institute of Pediatrics in 2019 were retrospectively analyzed. The patient was a seven year old girl, her main clinical manifestations included short stature (well below -2 standard deviations), obesity and breast development. The results of laboratory testing indicated that the level of thyrotropin (TSH)>100 mIU/L and the level of free thyroxine (FT 4) was 5.15 pmmol/L; serum estradiol and prolactin levels were significantly elevated; the gonadotropin-releasing hormone(GnRH) stimulation test showed that the gonad axis was not activated. She had giant ovarian cyst, pituitary hyperplasia, anemia and pericardial effusion. Bone age was delayed; and her blood lipids had increased. Therefore, she was diagnosed as Van Wyk-Grumbach syndrome. The patient received the treatment of levothyroxine, the drug does was gradually increased from 25 μg per day to 75 μg per day, vaginal bleeding was followed by medication for 3 days. Three months later, her thyroid function was back to normal, and giant ovarian cyst regressed, but the ovaries were bulky,pericardial effusion was absorbed. The levothyroxine dose was adjusted to 50 μg per day according to the test result of thyroid function. And 1 year late the thyroid function was normal, pituitary magnetic resonance imaging(MRI) showed the hyperplastic adenohypophysis was back to normal, no more vaginal bleeding occurred, and the giant ovarian cyst was shrunk.

Spontaneous ovarian hyperstimulation syndrome in a young female subject with a lingual thyroid and primary hypothyroidism

No abstract available.

Spontaneous ovarian hyperstimulation syndrome in a young female subject with a lingual thyroid and primary hypothyroidism

No abstract available.

Unusual Presentation of Primary Hypothyroidism.

Primary hypothyroidism may present with myriad of unusual presentation apart from typically described signs and symptoms. We report an unusual case of primary hypothyroidism clinically presenting as acute psychosis and radiologically mimicking as pituitary macroadenoma. A 19-year-old female presented with h/o abnormal behaviour in the form of auditory hallucination, fearfulness, loss of memory and inability to recognise family members six months back. She also gave h/o multiple joint pain, easy fatigability, facial puffiness, somnolence, progressive weight gain, constipation and cold intolerance for similar duration. MRI brain revealed enlarged pituitary, while the thyroid function analysis pointed towards primary hypothyroidism. Patient improved with LT4.

Hiperplasia hipofisaria secundaria a hipotiroidismo primario / Pituitary hyperplasia secondary to primary hipothyroidism

Paciente mujer de 15 años referida por diagnóstico de hipotiroidismo e hiperprolactinemia, con tratamiento irregular para ambas patologías, quien presentó pérdida de conocimiento en dos oportunidades, motivo por el cual se le indicó resonancia magnética (RM) de cerebro, en la cual se evidenció imagen tumoral hipofisaria que desplazaba el quiasma óptico. Se le indicó tratamiento con levotiroxina 50 ug por 1 semana, luego 100 ug diario. Los controles hormonales posteriores mostraron normalización, la RM de control evidenció disminución de tamaño de la imagen tumoral en aproximadamente 3 mm, sin repercusión en las estructuras supraselares o paraselares, con mejoría de cuadro clínico luego del tratamiento de sustitución con hormona tiroidea.

A 15 year-old woman with diagnosis of hypothyroidism and hyperprolactinemia had irregular treatment. She lost conscience twice and magnetic resonance (MR) was indicated. It showed image of pituitary tumor that displaced optic chiasm. She was prescribed levothyroxin 50 ug for one week and then 100 ug daily. Hormonal treatment produced normalization of hormonal values and magnetic resonance evidenced 3 mm tumor reduction without supraselar extension.

Approach to the patient with primary hypothyroidism accompanied by pituitary hyperplasia and increased serum creatine kinase level / 中华内分泌代谢杂志

Pituitary hyperplasia may be found in patients with primary hypothyroidism as the decreased thyroid hormone level attenuates negative feedback effect.Sometimes the enlarged pituitary may be misdiagnosed as a pituitary tumor.Patients with long term untreated hypothyroidism often have extremely high level of serum creatine kinase and thus may be misdiagnosed as suffering from myositis.In order to increase the awareness of the nonspecific symptoms of primary hypothyroidism,this article introduces the diagnosis and treatment of a patient with primary hypothyroidism with raised serum creatine kinase level and pituitary hyperplasia.

Pituitary Hyperplasia in Children with Short Stature and Primary Hypothyroidism.

We present eight cases with short stature, pituitary hyperplasia, and hypothyroidism. Pituitary hyperplasia due to primary hypothyroidism was diagnosed on the basis of clinical manifestations, endocrine examination and MRI. After 2 to 6 months of L-thyroxine replacement therapy, the signs of hypothyroidism disappeared; free triiodothyronine, free thyroxine, thyrotropin and prolactin became normal; and pituitary enlargement regressed. In two children, the growth rate remained low when treated with L-thyroxine, but with additional recombinant human growth hormone (rhGH), the height increased by 11 cm per year. No recurrence of lesions was found on follow-up.

Clinical analysis of 32 cases of pituitary hyperplasia secondary to primary hypothyroidism / 中华内分泌代谢杂志

Objective To improve the recognition of pituitary hyperplasia secondary to primary hypothyroidism by analyzing clinical and imaging data. Methods The clinical features, hormone data,imaging findings, and treatment were reviewed in 32 patients with pituitary hyperplasia secondary to primary hypothyroidism in Huashan Hospital from 1999 to 2008. Results Thirty-two patients, most juvenile,presented clinical and imaging features suggestive of functional primary pituitary adenoma. The dose of levothyroxine was increased to maintain the thyrotropin concentration at normal values. Following adequate thyroxine replacement, pituitary hyperplasia regressed on average within 6 months. Conclusions Pituitary hyperplasia secondary to primary hypothyroidism seems to be quite prevalent in children and adolescents.Complete regression will be achieved with thyroxine replacement therapy.

A Case of Sublingual Thyroid Combined with Pituitary Hyperplasia / 대한소아내분비학회지

We present a 23months old male patient of pituitary hyperplasia due to sublingual thyroid induced primary hypothyroidism with subsequent return to normal size after thyroxine therapy. Before the levothyroxine treatment, MRI revealed enlargement of the pituitary gland with suprasellar extension. During treatment with levothyroxine, serum T3, T4, and TSH were normal and growth retardation was improved. One year later, repeated MRI showed a decrease in pituitary mass size, with no suprasellar extension. The reversible pituitary mass resolved after treatment with levothyroxine must be considered in patients with pituitary and suprasellar masses.

Present Stutus and Perspectives of Androgen Replacement Therapy / 대한내분비학회지

No abstract available.

A Case of Piouitary Hyperplasia with Retardation due to Primary Hypothyroidism / 대한내분비학회지

Primary hypothyroidism can result in reactive enlargement of the pituitary gland which is indistinguishable from primary pituitary lesions in clinical presentation and on magnetic resonance imaging. A 17-year-old girl came to the hospital due to short stature, general weakness and galac-torrhea. The magnetic resonance imaging (MRI) study showed pitutary enlargement. The hormone study showed hyperprolactinemia, decreased basal growth hormone level and primary hypothyroi-dism. By thyroid replacement therapy only, mass was successfully regressed on follow up MRI after 4 months, and growth acceleration could be achieved.

Two Cases of Pituitary Hyperplasia Secondary to Primary Hypothyroidism Mimicking Pituitary Tumor / 대한소아내분비학회지

Pituitary adenoma should be differentiated diagnostically from pituitary hyperplasia, which can be classified by primary, secondary & tertially caused by ectopic tumors. Two cases with marked pituitary enlargement secondary to primary hypothyroidism were reported. The volume of the sellar turcica correlates with circulating TSH level. The subsequent regression with thryoxine therapy indicated hyperplasia rather than adenoma. This observation emphasizes the importance of diagnosing and treating primary hypothyroidism prior to considering surgery for possible pituitary adenoma. A brief review of related literatures was also made.