Pituitary hyperplasia secondary to primary hypothyroidism

Quintero, Beatriz Martinez; Yazbeck, Cynthia F.

doi:10.1002/ccr3.2863

Cited by 4 publications

(2 citation statements)

References 1 publication

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“…The literature search yielded 649 potentially relevant articles, spanning from January 1996 to December 2023. Following the removal of duplicates and the review of titles, abstracts, and full-length articles, we identified 55 articles [ 6 , 9 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 ,…”

Section: Resultsmentioning

confidence: 99%

Pituitary Hyperplasia Due to Longstanding Primary Hypothyroidism: A Case Report and Comprehensive Review of the Literature

Roux,

Rosso,

Cuboni

et al. 2024

Biomedicines

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Hypothyroidism is a frequently diagnosed endocrine disorder. Common signs and symptoms include fatigue, cold intolerance, hoarseness, dry skin, constipation, a slow relaxation phase of deep tendon reflexes, and bradycardia. However, some patients may exhibit atypical signs and symptoms, which can result in diagnostic confusion. Pituitary hyperplasia resulting from longstanding primary hypothyroidism was first described by Niepce in 1851. It is usually asymptomatic, but sometimes, in addition to symptoms of overt hypothyroidism, patients may complain of headaches, hypopituitarism, visual field impairment, and hyperprolactinemia. Furthermore, on imaging, pituitary hyperplasia can be mistaken for a pituitary adenoma. Distinguishing between the two is crucial, as their management differs; the former often responds to thyroid hormone replacement therapy, while the latter might need treatment with surgery and/or radiotherapy. Here we describe a patient who developed pituitary hyperplasia in the setting of longstanding uncompensated primary hypothyroidism due to a lack of compliance with levothyroxine replacement therapy. We also review the clinical, laboratory, and radiologic findings of the case reports available in the literature up to now in order to improve the knowledge and the care of the disease.

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Section: Resultsmentioning

confidence: 99%

Pituitary Hyperplasia Due to Longstanding Primary Hypothyroidism: A Case Report and Comprehensive Review of the Literature

Roux,

Rosso,

Cuboni

et al. 2024

Biomedicines

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show abstract

“…Additionally, to re ect the pituitary gland's vast regulatory role in the body, we initially sought to investigate relationships between pituitary [68Ga]-DOTATATE uptake and clinical variables such as FSH, menopause, TSH, oral contraception (OCP) use, BMI, and other forms of exogenous hormones, where were not included in the nal analysis due to di culties accessing the data, inconsistent documentation, and general scarcity of such information in the electronic medical record. Pituitary gland volume may change with oral contraceptive use, pregnancy, nulliparity, hormone replacement therapy, obesity, and primary hypothyroidism [35][36][37][38][39][40][41]. Future studies in relation to the aforementioned variables will further enhance our understanding of [68Ga]-DOTATATE PET in various clinical settings.…”

Section: Discussionmentioning

confidence: 99%

[68 Ga]-DOTATATE PET/MR-based evaluation of physiologic somatostatin receptor 2 expression in the adult pituitary gland as a function of age and sex in a prospective cohort

Kim,

Chang,

Dobri

et al. 2023

Pituitary

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The pituitary gland has the fourth highest physiologic avidity of [68Ga]-DOTATATE. In order to guide our understanding of [68Ga]-DOTATATE PET in clinical contexts, accurate characterization of the normal pituitary gland is rst required. This study aimed to characterize the normal pituitary gland using dedicated brain [68Ga]-DOTATATE PET/MRI as a function of age and sex. MethodsA total of 95 patients with a normal pituitary gland underwent brain [68Ga]-DOTATATE PET examinations for the purpose of diagnosing CNS SSTR2 positive tumors (mean age: 58.9, 73% female). Maximum SUV of the pituitary gland was obtained in each patient. SUV of superior sagittal sinus was obtained to calculate normalized SUV score (SUVR) of the gland. The anatomic size of the gland was collected as maximum sagittal height (MSH). Correlations with age and sex were analyzed. ResultsThe mean SUV and SUVR of the pituitary gland were 17.6 (range: 7-59.5, SD = 7.1) and 13.8 (range: 3.3-52.6, SD = 7.2), respectively. Older females had signi cantly higher SUV of the pituitary gland compared to younger females. When strati ed by age and sex, both older and younger females had signi cantly higher pituitary SUV than older males. SUVR did not differ signi cantly by age or sex. MSH of the pituitary gland in younger females was signi cantly greater than in younger males at all age cutoffs. ConclusionThis study provides an empiric pro ling of the physiological [68Ga]-DOTATATE avidity of the pituitary gland. The ndings suggest that SUV may vary by age and sex and can help guide the use of [68Ga]-DOTATATE PET/MRI in clinical and research settings. Future studies can build on these ndings to investigate further the relationship between pituitary biology and demographic factors.

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Reduced pituitary size in subjects with mutations in the THRB gene and thyroid hormone resistance

Heldmann

Chatterjee

Moran

et al. 2022

Endocrine Connections

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Background: Thyroid hormone action is mediated by two forms of thyroid hormone receptors (α,β) with differential tissue distribution. Thyroid hormone receptor β (TRβ) mutations lead to resistance to thyroid hormone action in tissues predominantly expressing the β form of the receptor (pituitary, liver). This study seeks to identify effects of mutant TRβ on pituitary size. Methods: High-resolution 3D T1-weighted magnetic resonance images were acquired in 19 patients with RTHβ in comparison to 19 healthy matched controls. Volumetric measurements of the pituitary gland were performed independently and blinded by four different raters (two neuroradiologists, one neurologist, one neuroscientist). Results: Patients with mutant TRβ (Resistance to Thyroid Hormone β,RΤΗβ) showed elevated fT3/4 levels with normal TSH levels, whereas healthy controls showed normal thyroid hormone levels. Imaging revealed smaller pituitary size in RTHβ patients in comparison to healthy controls (F(1,35)=7.05, p=0.012, partial η2 =0.17). Conclusion: RTHβ subjects have impaired sensitivity to thyroid hormones, along with decreased size of the pituitary gland.

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Pituitary hyperplasia secondary to primary hypothyroidism

Abstract: Severe primary hypothyroidism should be considered in the differential diagnosis of pituitary enlargement. Thyroid hormone replacement therapy should lead to regression of pituitary hyperplasia.

Cited by 4 publications

References 1 publication

Pituitary Hyperplasia Due to Longstanding Primary Hypothyroidism: A Case Report and Comprehensive Review of the Literature

Pituitary Hyperplasia Due to Longstanding Primary Hypothyroidism: A Case Report and Comprehensive Review of the Literature

[68 Ga]-DOTATATE PET/MR-based evaluation of physiologic somatostatin receptor 2 expression in the adult pituitary gland as a function of age and sex in a prospective cohort

Reduced pituitary size in subjects with mutations in the THRB gene and thyroid hormone resistance

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