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The pituitary-thyroid axis in patients with pituitary disorders.
Horm Metab Res. 1989 Jul; 21(7):387-90.HM

Abstract

The pituitary-thyroid axis of 12 patients, exposed to transsphenoidal pituitary microsurgery because of nonfunctioning adenomas (6), prolactinomas (3) and craniopharyngioma (1), or to major pituitary injury (1 apoplexy, 1 accidental injury), was controlled more than 6 months following the incidents. The patients did not receive thyroid replacement therapy and were evaluated by measurement of the serum concentration of thyroxine (T4), 3,5,3'-triiodothyronine (T3), 3,3',5'-triiodothyronine (rT3), T3-resin uptake test and thyrotropin (TSH, IRMA method) before and after 200 micrograms thyrotropin releasing hormone (TRH) iv. The examination also included measurement of prolactin (PRL) and cortisol (C) in serum. Apart from 1 patient with pituitary apoplexy all had normal basal TSH levels and 9 showed a significant TSH response to TRH. Compared to 40 normal control subjects the 12 patients had significantly decreased levels of T4, T3 and rT3 (expressed in free indices), while the TSH levels showed no change. Five of the patients, studied before and following surgery, had all decreased and subnormal FT4I (free T4 index) after surgery, but unchanged FT3I and TSH. The levels of FT4I were positively correlated to both those of FT3I and FrT3I, but not to TSH. The TSH and thyroid hormone values showed no relationship to the levels of PRL or C of the patients exposed to surgery. It is concluded that the risk of hypothyroidism in patients exposed to pituitary microsurgery is not appearing from the TSH response to TRH, but from the thyroid hormone levels.

Authors+Show Affiliations

Medical Department, Horsens Hospital, Denmark.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

2506120

Citation

Eskildsen, P C., et al. "The Pituitary-thyroid Axis in Patients With Pituitary Disorders." Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Metabolisme, vol. 21, no. 7, 1989, pp. 387-90.
Eskildsen PC, Kruse A, Kirkegaard C. The pituitary-thyroid axis in patients with pituitary disorders. Horm Metab Res. 1989;21(7):387-90.
Eskildsen, P. C., Kruse, A., & Kirkegaard, C. (1989). The pituitary-thyroid axis in patients with pituitary disorders. Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Metabolisme, 21(7), 387-90.
Eskildsen PC, Kruse A, Kirkegaard C. The Pituitary-thyroid Axis in Patients With Pituitary Disorders. Horm Metab Res. 1989;21(7):387-90. PubMed PMID: 2506120.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The pituitary-thyroid axis in patients with pituitary disorders. AU - Eskildsen,P C, AU - Kruse,A, AU - Kirkegaard,C, PY - 1989/7/1/pubmed PY - 1989/7/1/medline PY - 1989/7/1/entrez SP - 387 EP - 90 JF - Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme JO - Horm. Metab. Res. VL - 21 IS - 7 N2 - The pituitary-thyroid axis of 12 patients, exposed to transsphenoidal pituitary microsurgery because of nonfunctioning adenomas (6), prolactinomas (3) and craniopharyngioma (1), or to major pituitary injury (1 apoplexy, 1 accidental injury), was controlled more than 6 months following the incidents. The patients did not receive thyroid replacement therapy and were evaluated by measurement of the serum concentration of thyroxine (T4), 3,5,3'-triiodothyronine (T3), 3,3',5'-triiodothyronine (rT3), T3-resin uptake test and thyrotropin (TSH, IRMA method) before and after 200 micrograms thyrotropin releasing hormone (TRH) iv. The examination also included measurement of prolactin (PRL) and cortisol (C) in serum. Apart from 1 patient with pituitary apoplexy all had normal basal TSH levels and 9 showed a significant TSH response to TRH. Compared to 40 normal control subjects the 12 patients had significantly decreased levels of T4, T3 and rT3 (expressed in free indices), while the TSH levels showed no change. Five of the patients, studied before and following surgery, had all decreased and subnormal FT4I (free T4 index) after surgery, but unchanged FT3I and TSH. The levels of FT4I were positively correlated to both those of FT3I and FrT3I, but not to TSH. The TSH and thyroid hormone values showed no relationship to the levels of PRL or C of the patients exposed to surgery. It is concluded that the risk of hypothyroidism in patients exposed to pituitary microsurgery is not appearing from the TSH response to TRH, but from the thyroid hormone levels. SN - 0018-5043 UR - https://www.unboundmedicine.com/medline/citation/2506120/The_pituitary_thyroid_axis_in_patients_with_pituitary_disorders_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2007-1009244 DB - PRIME DP - Unbound Medicine ER -