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[Hyperthyroidism caused by a TSH producing pituitary adenoma].
Acta Med Austriaca. 1999; 26(1):32-6.AM

Abstract

Elevated levels of free triiodothyronine (fT3) of 8.8 ng/dl (normal range 2.0 to 4.2) and free thyroxin (fT4) of 3.5 pg/ml (0.8 to 1.7) were found in the course of an examination of a 53-year old patient due to a planned hysterectomy. As thyrotropin (TSH) also was elevated with 5.8 mU/l (0.4 to 4.5), these findings corresponded to an inappropriate secretion of TSH (IST). Additional examinations revealed a blunted rise of TSH secretion after i.v. injection of 200 micrograms thyrotropin releasing hormone (TRH) as well as lacking suppression of TSH secretion after oral doses of 75 micrograms T3 during one week. alpha-TSH levels with 3.7 micrograms/l were elevated in comparison to a matched normal sample just as the molar ratio alpha-TSH/TSH with 6.95 and sex hormone-binding globulin (SHBG) with 175 nmol/l and showed an absence of inhibition in the T3 suppression test. These results were suggestive of neoplastic inappropriate secretion of TSH (nIST) due to a TSH-secreting pituitary adenoma. In concordance, the magnetic resonance imaging (MRI) showed a 1 cm tumor in the sella. The adenoma could also be visualized by 111In-octreotide and 123I-epidepride scintigraphies of the pituitary gland. After transsphenoidal resection, histological examination of the tumor resulted in the finding of a TSH-secreting adenoma. Postoperative TSH levels were not detectable, indicating the complete removal of the adenoma. Levels of fT3 and fT4 were slightly below normal with 1.9 pg/ml and 0.7 ng/dl, respectively. A control scintigraphy with 111In-octreotide following an equivocal MRI showed no uptake in the pituitary.

Authors+Show Affiliations

Institut für Nuklearmedizin, Krankenhaus Lainz.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

ger

PubMed ID

10230475

Citation

Prasch, F, et al. "[Hyperthyroidism Caused By a TSH Producing Pituitary Adenoma]." Acta Medica Austriaca, vol. 26, no. 1, 1999, pp. 32-6.
Prasch F, Knosp SE, Steinbach R, et al. [Hyperthyroidism caused by a TSH producing pituitary adenoma]. Acta Med Austriaca. 1999;26(1):32-6.
Prasch, F., Knosp, S. E., Steinbach, R., Wogritsch, S., Hurtl, I., Greifeneder, M., Holm, C., Najemnik, C., & Dudczak, R. (1999). [Hyperthyroidism caused by a TSH producing pituitary adenoma]. Acta Medica Austriaca, 26(1), 32-6.
Prasch F, et al. [Hyperthyroidism Caused By a TSH Producing Pituitary Adenoma]. Acta Med Austriaca. 1999;26(1):32-6. PubMed PMID: 10230475.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Hyperthyroidism caused by a TSH producing pituitary adenoma]. AU - Prasch,F, AU - Knosp,S E, AU - Steinbach,R, AU - Wogritsch,S, AU - Hurtl,I, AU - Greifeneder,M, AU - Holm,C, AU - Najemnik,C, AU - Dudczak,R, PY - 1999/5/7/pubmed PY - 1999/5/7/medline PY - 1999/5/7/entrez SP - 32 EP - 6 JF - Acta medica Austriaca JO - Acta Med Austriaca VL - 26 IS - 1 N2 - Elevated levels of free triiodothyronine (fT3) of 8.8 ng/dl (normal range 2.0 to 4.2) and free thyroxin (fT4) of 3.5 pg/ml (0.8 to 1.7) were found in the course of an examination of a 53-year old patient due to a planned hysterectomy. As thyrotropin (TSH) also was elevated with 5.8 mU/l (0.4 to 4.5), these findings corresponded to an inappropriate secretion of TSH (IST). Additional examinations revealed a blunted rise of TSH secretion after i.v. injection of 200 micrograms thyrotropin releasing hormone (TRH) as well as lacking suppression of TSH secretion after oral doses of 75 micrograms T3 during one week. alpha-TSH levels with 3.7 micrograms/l were elevated in comparison to a matched normal sample just as the molar ratio alpha-TSH/TSH with 6.95 and sex hormone-binding globulin (SHBG) with 175 nmol/l and showed an absence of inhibition in the T3 suppression test. These results were suggestive of neoplastic inappropriate secretion of TSH (nIST) due to a TSH-secreting pituitary adenoma. In concordance, the magnetic resonance imaging (MRI) showed a 1 cm tumor in the sella. The adenoma could also be visualized by 111In-octreotide and 123I-epidepride scintigraphies of the pituitary gland. After transsphenoidal resection, histological examination of the tumor resulted in the finding of a TSH-secreting adenoma. Postoperative TSH levels were not detectable, indicating the complete removal of the adenoma. Levels of fT3 and fT4 were slightly below normal with 1.9 pg/ml and 0.7 ng/dl, respectively. A control scintigraphy with 111In-octreotide following an equivocal MRI showed no uptake in the pituitary. SN - 0303-8173 UR - https://www.unboundmedicine.com/medline/citation/10230475/[Hyperthyroidism_caused_by_a_TSH_producing_pituitary_adenoma]_ DB - PRIME DP - Unbound Medicine ER -