Pituitary Enlargement in Patients With Primary Hypothyroidism

Khawaja, Nahla; Taher, B; Barham, Muries; Naser, Abeer A; Hadidy, Azmy M.; Ahmad, Azmi T.; Hamamy, Hanan; Yaghi, Nakhleh A; Ajlouni, Kamel

doi:10.4158/ep.12.1.29

Cited by 71 publications

(53 citation statements)

References 24 publications

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“…This would suggest a pathogenic relationship between the two entities, as fluctuations in gland function (either natural or induced by replacement therapy) may lead to regression of the compensatory hyperplasia of the anterior pituitary and to cisternal herniation. In fact, several authors show that primary hypothyroidism results in an increased pituitary mass, which reverses after thyroxine replacement therapy [4,[19][20][21][22], and reversal of the hyperprolactinemia or amenorrhea-galactorrhea syndrome that often accompanies it [23][24][25][26][27][28]. Similar cases have been described, such as macroadenoma or suprasellar mass [29][30][31][32][33][34][35][36][37], which also regressed with replacement therapy, although some cases required surgery when there was compression of the chiasma [8].…”

Section: Discussionmentioning

confidence: 73%

Empty sella and primary autoimmune hypothyroidism

et al. 2009

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In order to assess the association between empty sella (ES) and primary autoimmune hypothyroidism, and the possibility of a common pathogenesis. We retrospectively studied all patients with presumed ES diagnosed in the last 20 years, most of whom were treated by our Endocrinology Department. Subjects with a known etiology were excluded. Incomplete records or those with a doubtful diagnosis were also excluded. A total of 56 subjects were included in the study. ES was diagnosed by pituitary MRI. The measurement of free T4, TSH, and antithyroid antibodies (TPOAb and TgAb) was assayed using commercial kits. The cases of hypothyroidism obtained were compared with those in another group of similar patients, diagnosed with diabetes mellitus type 2, through chi2 test. A total of 15 (26.78%) patients of 56 with ES had autoimmune thyroid disease (subclinical or clinical hypothyroidism). Primary hypothyroidism with negative antithyroid autoantibodies was found in a further 13 patients (23.21%). The 46.42% of ES had primary hypothyroidism; this result had obtained a statistically significant difference when compared to the ratio obtained in the group of diabetes mellitus type 2 (P < 0.0029). There is an important association between ES and autoimmune thyroid disease, which reached 26.78% in our series. We suggest the possibility of a common pathogenesis for certain cases of ES and autoimmune thyroid disease, with the end point of ES in the pituitary, and atrophy in the thyroid gland.

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Section: Discussionmentioning

confidence: 73%

Empty sella and primary autoimmune hypothyroidism

et al. 2009

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“…In a cohort of patients with primary hypothyroidism 70% had pituitary enlargement on MRI 32. In an earlier study 71% had visual field defects on Goldmann perimetry, although only 14% of these were symptomatic, and the typical changes were restriction to the central visual field, with peripheral vision being less commonly affected 33.…”

Section: Visual Symptomsmentioning

confidence: 89%

When to consider thyroid dysfunction in the neurology clinic

Mistry¹,

Wass²,

Turner

2009

Practical Neurology

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There are many neurological manifestations of thyroid disease, and thyroid function has taken its place in the "routine bloods" of neurology practice. However, although conditions such as carpal tunnel syndrome prompt thyroid testing despite any clear evidence for this approach, other symptoms of potential significance in terms of thyroid disease may be overlooked in the busy general neurology clinic, or abnormal thyroid tests may be assumed to be incidental. Psychiatric disorders, loss of consciousness, movement disorders and weakness may all be manifestations of primary thyroid disease. This is a symptom-based review where we will consider the evidence (or lack of it) for the association of various neurological problems with thyroid dysfunction, and also the pitfalls in interpretation of the biochemical tests.

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“…Neoplastic transformation from pituitary hyperplasia is rare but well documented. Persistent hyperstimulation may lead the hyperplastic cell to acquire autonomy and progress to neoplasm (6) .…”

Section: Discussionmentioning

confidence: 99%