[Endocrine polyadenomatosis associated with prolactin pituitary adenoma and an intrathyroidal parathyroid adenoma]. / Polyadénomatose endocrinienne associant un adénome hypophysaire à prolactine et un adénome parathyroïdien intrathyroïdien

A pituitary adenoma was removed transsphenoidally from a 20-yr-old woman with secondary amenorrhea, galactorrhea, and hyperprolactinemia. Light and electronic microscopy, immunocytology characterized a prolactin cell tumor. The patient also underwent three surgical explorations for hyperparathyroidism. Only after selective catheterization of thyroid veins with radioimmunoassay for parathormone, an intrathyroidal parathyroid adenoma was found. No other case of proven prolactin adenoma in Wermer's syndrome has been reported.

Thyroid iodine organification defects: a case with lack of thyroglobulin iodination and a case without any peroxidase activity.

Two patients (G2, G3) with iodine organification defect were studied. The first patient (G2), a 25-year-old women with no clinical hypothyroidism, had had her goiter for 10 years; 62% of the thyroidal iodine was released by perchlorate indicating iodine organification defect. The thyroid tissue obtained at thyroidectomy contained a normal concentration of thyroid peroxidase (I2 formation from I-) when tested after solubilization of the enzyme by trypsin and digitonin treatment of the particulate material. 1. The enzymatic activity (G2-TPO) behaved on DEAE cellulose chromatography very differently from those of hog (P-TPO) or another human goiter peroxidase (G1-TPO) (Pommier, et al., J Clin Endocrinol Metab 39: 69, 1974): the molarity of elution was 2M NaCl instead of 0.15 mM. 2. Both P-TPO and G2-TPO catalyzed iodide peroxidation (I- leads to I2) but the Km (iodide) value for G2-TPO was much lower (2.3 x 10(-2) M) when compared with that of P-TPO (3.7 x 10(-3) M) or G1-TPO (3.5 x 10(-3) M). In addition, the optimum pH for this reaction differed markedly (pH 6.1 instead of 7.9). 3. G2-TPO was poorly efficient in catalyzing the oxidation of gaiacol to tetragaiacol. 4. G2-TPO was unable to perform the iodination of non-iodinated goiter thyroglobulin whatever the pH and the iodide concentration. 5. Thyroglobulin from this goiter (G2) was almost not iodinated (0.0014%), i.e., 0.07 atoms iodine/mole thyroglobulin), and its total content in the gland was very low (0.3-4 g/1000 g wet tissue instead of 25 g). A clear discrepancy was thus shown between the euthyroid state of this patient and the total lack of iodinating activity of the isolated peroxidase. The second patient (G3), a 17-year-old man with clinical hypothyroidism, had had his goiter for 5 years. 100% of the thyroidal iodine was released by perchlorate indicating a complete iodine organification defect. The thyroid tissue obtained at thyroidectomy contained no peroxidase activity when tested before and after treatment of the particulate material by trypsin and digitonin and even in the presence of hematin. Thyroglobulin from this goiter, which was almost non-iodinated (0.0014%), was present in normal amounts in the gland (congruent to 25 g/1000 g).

[Prolactin adenoma. Study of gonadotrophic function by the sassoles G LHRH test]. / Adénome à prolactine. Etude de la fonction gonadotrope par l'épreuve à la LHRH. Dix cas

An intravenous injection of synthetic LHRH (50mug) was given in 10 patients with prolactin secreting pituitary adenomas. Variations in circulating levels of gonadotrophic hormones were measured by radioimmunological estimation. The increase in blood level of luteinizing hormone was constant, low in three cases, normal in 3 and high in 4. An increase in follicle stimulating hormone (FSH) was absent in only two cases. The data obtained indicates the absence of any characteristic value of the LHRH test in the aetiological diagnosis of amenorrhoea/galactorrhoea syndromes. They represent an argument in favour of the relative character and of the functional nature of the gonadotrophic insufficiency of prolactin adenomas.