Central Hyperthyroidism

TSH-secreting pituitary adenoma: a rare cause of hyperthyroidism Central hyperthyroidism is noted in a 35-year-old man with recurrent panic attacks. Thyroid-stimulating hormone-secreting pituitary adenoma (TSH-secreting adenoma) is found to be the underlying etiology. A pituitary adenomectomy is carried out, with regression of the symptoms and hyperthyroidism. TSH-secreting adenomas are rare and cause hyperthyroidism due to autonomous TSH secretion. In addition to hyperthyroidism, dysfunction of other pituitary axes and neurological problems due to local compression may also be present. Biochemically, TSH adenoma is characterized by elevated levels of thyroid hormones without suppression of the TSH concentration. After analytical interference has been ruled out, additional biochemical and radiological investigations are necessary in the differential diagnosis and to establish diagnostic certainty. Neurosurgical resection is the cornerstone of the treatment, although radiotherapy and somatostatin analogs may also be considered.

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Somatostatin receptor ligands induce TSH deficiency in thyrotropin-secreting pituitary adenoma

Acta Endocrinologica ◽

10.1530/eje-20-0484 ◽

2021 ◽

Vol 184 (1) ◽

pp. 1-8

Author(s):

Frédéric Illouz ◽

Philippe Chanson ◽

Emmanuel Sonnet ◽

Thierry Brue ◽

Amandine Ferriere ◽

...

Keyword(s):

Pituitary Adenoma ◽

Somatostatin Receptor ◽

Receptor Ligands ◽

First Line ◽

First Line Therapy ◽

Line Therapy ◽

Somatostatin Receptor Ligands ◽

Central Hyperthyroidism ◽

Long Acting ◽

Tsh Deficiency

Objective Somatostatin receptor ligands (SRL) are useful to control central hyperthyroidism in patients with thyrotropin-secreting pituitary adenoma (TSH pituitary adenoma). The aim of this study was to describe the frequency of thyrotropin deficiency (TSH deficiency) in patients with TSH pituitary adenoma treated by SRL. Design Retrospective study. Methods Patients with central hyperthyroidism due to TSH pituitary adenoma treated by short or long-acting SRL were retrospectively included. TSH deficiency was defined by a low FT4 associated with non-elevated TSH concentrations during SRL therapy. We analysed the frequency of TSH deficiency and the characteristics of patients with or without TSH deficiency. Results Forty-six patients were included. SRL were used as the first-line therapy in 21 of 46 patients (46%). Central hyperthyroidism was controlled in 36 of 46 patients (78%). TSH deficiency appeared in 7 of 46 patients (15%) after a median time of 4 weeks (4–7) and for a median duration of 3 months (2.5–3). The TSH deficiency occurred after one to three injections of long-acting SRL used as first-line therapy in 6/7 cases. There were no differences in terms of clinical and hormonal features, size of adenomas or doses of SRL between patients with or without TSH deficiency. Conclusions SRL can induce TSH deficiency in patients with central hyperthyroidism due to TSH pituitary adenoma. Thyrotropic function should be assessed before the first three injections of SRL in order to track TSH deficiency and reduce the frequency of injections when control of thyrotoxicosis rather than tumour reduction is the aim of the treatment.

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"Central hyperthyroidism": the syndrome of inappropriate thyrotropin secretion

Acta Endocrinologica ◽

10.1530/acta.0.107s074 ◽

1984 ◽

Vol 104 (4_Supplb) ◽

pp. S74 ◽

Cited By ~ 1

Author(s):

J. JOOST ◽

R. HEHRMANN ◽

H. L. KRÜSKEMPER

Keyword(s):

Central Hyperthyroidism

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Monomorphous Plurihormonal Pituitary Adenoma of Pit-1 Lineage in a Giant Adolescent with Central Hyperthyroidism

Endocrine Pathology ◽

10.1007/s12022-015-9395-2 ◽

2015 ◽

Vol 27 (1) ◽

pp. 25-33 ◽

Cited By ~ 10

Author(s):

Bernardo Dias Pereira ◽

Luísa Raimundo ◽

Ozgur Mete ◽

Ana Oliveira ◽

Jorge Portugal ◽

...

Keyword(s):

Pituitary Adenoma ◽

Central Hyperthyroidism ◽

Plurihormonal Pituitary Adenoma

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Pituitary thyrotoxicosis presenting as abnormal thyroid function testing during pregnancy: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02734-4 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

David George Jackson ◽

John Parker ◽

Thomas Cummings

Keyword(s):

Thyroid Function ◽

Multinodular Goiter ◽

Thyroid Stimulating Hormone ◽

White Female ◽

Common Symptom ◽

Euthyroid State ◽

Thyroid Function Testing ◽

Central Hyperthyroidism ◽

Function Testing ◽

Stimulating Hormone

Abstract Background Central hyperthyroidism is a rare form of hyperthyroidism caused by thyrotrope pituitary adenomas. It is characterized by elevated thyroid-stimulating hormone alongside high thyroxine and triiodothyronine. Goiter is the most common symptom of central hyperthyroidism. Surgical resection as well as somatostatin analog therapy typically achieve resolution of hyperthyroid symptoms and restoration of a euthyroid state. Case presentation We report the case of a 30-year-old primigravida Caucasian/White female who presented with abnormal thyroid function testing results and multinodular goiter during pregnancy. Postpartum, she was found to have multinodular goiter on physical examination as well as persistent elevated thyroid-stimulating hormone with elevated free thyroxine and free triiodothyronine. Magnetic resonance imaging disclosed a large pituitary macroadenoma, and she subsequently underwent resection of the mass. She achieved a sustained euthyroid state postoperatively. Conclusions This case shows how central hyperthyroidism can present without the more apparent symptoms of thyrotoxicosis and that successful resolution of central hyperthyroidism may be achieved postoperatively.

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