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Clinical and molecular studies of a thyrotropin-secreting pituitary adenoma.
J Clin Endocrinol Metab. 1989 Jun; 68(6):1211-5.JC

Abstract

A 40-year-old woman, who had previously received radioactive iodine for hyperthyroidism, presumably due to Graves' disease, subsequently was found to have inappropriately elevated serum TSH and alpha-subunit levels and a pituitary adenoma. Detailed clinical studies revealed marked serum TSH elevations (approximately 100 mU/L) with no circadian variation, but with 7 pulses/24 h. Serum alpha-subunit levels averaged 2.5 micrograms/L, with 13 pulses/24 h. Neither serum TSH nor alpha-subunit responded to TRH stimulation, nor did serum TSH change during dopamine infusion, but alpha-subunit levels did decline slightly. In contrast, during somatostatin infusion, serum TSH declined to 30% of baseline levels, while alpha-subunit levels did not change. Pituitary adenoma tissue obtained at the time of transsphenoidal surgery immunostained weakly with anti-TSH beta serum and strongly with anti-alpha-subunit serum. Northern blot analysis of RNA isolated from the tumor revealed TSH beta and alpha-subunit mRNA levels of normal length, while primer extension analysis showed a major initiation site for the TSH beta gene that appeared to be identical in the tumor and normal pituitary tissue. A second minor upstream start site was detected in the tumor, but it represented less than 1% of transcription compared to the major downstream start site. We conclude that the tumor secreted TSH and alpha-subunit in an abnormal and discordant fashion, but that the TSH gene initiation site appeared to be normal and, therefore, did not explain the observed secretory abnormalities.

Authors+Show Affiliations

Department of Medicine (Endocrinology), University of Colorado Health Sciences Center, Denver 80262.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

2723029

Citation

Samuels, M H., et al. "Clinical and Molecular Studies of a Thyrotropin-secreting Pituitary Adenoma." The Journal of Clinical Endocrinology and Metabolism, vol. 68, no. 6, 1989, pp. 1211-5.
Samuels MH, Wood WM, Gordon DF, et al. Clinical and molecular studies of a thyrotropin-secreting pituitary adenoma. J Clin Endocrinol Metab. 1989;68(6):1211-5.
Samuels, M. H., Wood, W. M., Gordon, D. F., Kleinschmidt-DeMasters, B. K., Lillehei, K., & Ridgway, E. C. (1989). Clinical and molecular studies of a thyrotropin-secreting pituitary adenoma. The Journal of Clinical Endocrinology and Metabolism, 68(6), 1211-5.
Samuels MH, et al. Clinical and Molecular Studies of a Thyrotropin-secreting Pituitary Adenoma. J Clin Endocrinol Metab. 1989;68(6):1211-5. PubMed PMID: 2723029.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical and molecular studies of a thyrotropin-secreting pituitary adenoma. AU - Samuels,M H, AU - Wood,W M, AU - Gordon,D F, AU - Kleinschmidt-DeMasters,B K, AU - Lillehei,K, AU - Ridgway,E C, PY - 1989/6/1/pubmed PY - 1989/6/1/medline PY - 1989/6/1/entrez SP - 1211 EP - 5 JF - The Journal of clinical endocrinology and metabolism JO - J Clin Endocrinol Metab VL - 68 IS - 6 N2 - A 40-year-old woman, who had previously received radioactive iodine for hyperthyroidism, presumably due to Graves' disease, subsequently was found to have inappropriately elevated serum TSH and alpha-subunit levels and a pituitary adenoma. Detailed clinical studies revealed marked serum TSH elevations (approximately 100 mU/L) with no circadian variation, but with 7 pulses/24 h. Serum alpha-subunit levels averaged 2.5 micrograms/L, with 13 pulses/24 h. Neither serum TSH nor alpha-subunit responded to TRH stimulation, nor did serum TSH change during dopamine infusion, but alpha-subunit levels did decline slightly. In contrast, during somatostatin infusion, serum TSH declined to 30% of baseline levels, while alpha-subunit levels did not change. Pituitary adenoma tissue obtained at the time of transsphenoidal surgery immunostained weakly with anti-TSH beta serum and strongly with anti-alpha-subunit serum. Northern blot analysis of RNA isolated from the tumor revealed TSH beta and alpha-subunit mRNA levels of normal length, while primer extension analysis showed a major initiation site for the TSH beta gene that appeared to be identical in the tumor and normal pituitary tissue. A second minor upstream start site was detected in the tumor, but it represented less than 1% of transcription compared to the major downstream start site. We conclude that the tumor secreted TSH and alpha-subunit in an abnormal and discordant fashion, but that the TSH gene initiation site appeared to be normal and, therefore, did not explain the observed secretory abnormalities. SN - 0021-972X UR - https://www.unboundmedicine.com/medline/citation/2723029/Clinical_and_molecular_studies_of_a_thyrotropin_secreting_pituitary_adenoma_ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jcem-68-6-1211 DB - PRIME DP - Unbound Medicine ER -