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Hyperthyroidism due to a pituitary adenoma composed of two different cell types, one secreting alpha-subunit alone and another cosecreting alpha-subunit and thyrotropin.
J Clin Endocrinol Metab. 1991 Feb; 72(2):415-21.JC

Abstract

A 37-yr-old female presented with clinical signs and symptoms of mild hyperthyroidism, high serum levels of free T4 (24.2 pmol/L), free T3 (11.7 pmol/L), and sex hormone-binding globulin (157 nmol/L) as well as measurable (by immunofluorometric assay) serum TSH concentrations (1.9 mU/L) in the absence of any known methodological interference. The above finding indicated the presence of hyperthyroidism due to inappropriate secretion of TSH, whose neoplastic origin was documented by computed tomographic scan showing a 1-cm pituitary adenoma. The diagnosis was confirmed by elevated alpha-subunit levels (9.2 micrograms/L) and alpha-subunit/TSH molar ratio (25.2) as well as absent TSH suppression after T3 administration. TRH injection (200 microgram, iv) caused impaired TSH (from 3.0 to 4.8 mU/L) and unexpectedly exaggerated alpha-subunit (from 8.8 to 18.2 micrograms/L) responses. Such a discrepancy was also observed after other dynamic tests. Double gold particle immunostaining of the adenomatous tissue removed at surgery showed that all of the cells contained secretory granules positive for alpha-subunit, while very few cells were positive for TSH beta and alpha-subunit. In conclusion, the present study demonstrates the existence of TSH-induced hyperthyroidism due to a pituitary adenoma composed of two different cell types: one secreting alpha-subunit alone and another cosecreting alpha-subunit and TSH.

Authors+Show Affiliations

Department of Clinical and Biological Sciences, University of Turin, Italy.No 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
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

1704010

Citation

Terzolo, M, et al. "Hyperthyroidism Due to a Pituitary Adenoma Composed of Two Different Cell Types, One Secreting Alpha-subunit Alone and Another Cosecreting Alpha-subunit and Thyrotropin." The Journal of Clinical Endocrinology and Metabolism, vol. 72, no. 2, 1991, pp. 415-21.
Terzolo M, Orlandi F, Bassetti M, et al. Hyperthyroidism due to a pituitary adenoma composed of two different cell types, one secreting alpha-subunit alone and another cosecreting alpha-subunit and thyrotropin. J Clin Endocrinol Metab. 1991;72(2):415-21.
Terzolo, M., Orlandi, F., Bassetti, M., Medri, G., Paccotti, D., Cortelazzi, D., Angeli, A., & Beck-Peccoz, P. (1991). Hyperthyroidism due to a pituitary adenoma composed of two different cell types, one secreting alpha-subunit alone and another cosecreting alpha-subunit and thyrotropin. The Journal of Clinical Endocrinology and Metabolism, 72(2), 415-21.
Terzolo M, et al. Hyperthyroidism Due to a Pituitary Adenoma Composed of Two Different Cell Types, One Secreting Alpha-subunit Alone and Another Cosecreting Alpha-subunit and Thyrotropin. J Clin Endocrinol Metab. 1991;72(2):415-21. PubMed PMID: 1704010.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hyperthyroidism due to a pituitary adenoma composed of two different cell types, one secreting alpha-subunit alone and another cosecreting alpha-subunit and thyrotropin. AU - Terzolo,M, AU - Orlandi,F, AU - Bassetti,M, AU - Medri,G, AU - Paccotti,D, AU - Cortelazzi,D, AU - Angeli,A, AU - Beck-Peccoz,P, PY - 1991/2/1/pubmed PY - 1991/2/1/medline PY - 1991/2/1/entrez SP - 415 EP - 21 JF - The Journal of clinical endocrinology and metabolism JO - J Clin Endocrinol Metab VL - 72 IS - 2 N2 - A 37-yr-old female presented with clinical signs and symptoms of mild hyperthyroidism, high serum levels of free T4 (24.2 pmol/L), free T3 (11.7 pmol/L), and sex hormone-binding globulin (157 nmol/L) as well as measurable (by immunofluorometric assay) serum TSH concentrations (1.9 mU/L) in the absence of any known methodological interference. The above finding indicated the presence of hyperthyroidism due to inappropriate secretion of TSH, whose neoplastic origin was documented by computed tomographic scan showing a 1-cm pituitary adenoma. The diagnosis was confirmed by elevated alpha-subunit levels (9.2 micrograms/L) and alpha-subunit/TSH molar ratio (25.2) as well as absent TSH suppression after T3 administration. TRH injection (200 microgram, iv) caused impaired TSH (from 3.0 to 4.8 mU/L) and unexpectedly exaggerated alpha-subunit (from 8.8 to 18.2 micrograms/L) responses. Such a discrepancy was also observed after other dynamic tests. Double gold particle immunostaining of the adenomatous tissue removed at surgery showed that all of the cells contained secretory granules positive for alpha-subunit, while very few cells were positive for TSH beta and alpha-subunit. In conclusion, the present study demonstrates the existence of TSH-induced hyperthyroidism due to a pituitary adenoma composed of two different cell types: one secreting alpha-subunit alone and another cosecreting alpha-subunit and TSH. SN - 0021-972X UR - https://www.unboundmedicine.com/medline/citation/1704010/Hyperthyroidism_due_to_a_pituitary_adenoma_composed_of_two_different_cell_types_one_secreting_alpha_subunit_alone_and_another_cosecreting_alpha_subunit_and_thyrotropin_ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jcem-72-2-415 DB - PRIME DP - Unbound Medicine ER -