Avramides A, Karapiperis A, Triantafyllidou E, Vayas S, Moshidou A, Vyzantiadis A
Department of Endocrinology, Hippokration Hospital, Thessaloniki, Greece.
Acta Paediatr. 1992 Dec;81(12):1058-60. doi: 10.1111/j.1651-2227.1992.tb12177.x.
Graves' disease, multinodular toxic goiter or toxic adenoma are the usual causes of hyperthyroidism in children as well as in adults. We report a case of hyperthyroidism due to TSH-secreting pituitary macroadenoma in an 11-year-old girl. The patient was admitted to the Endocrine Department for pituitary function evaluation, five months after transfrontal adenomectomy and pituitary irradiation for a macroadenoma. On admission the patient was clinically hyperthyroid and the work-up established a diagnosis of hyperthyroidism due to TSH-secreting adenoma (high levels of TSH in the face of hyperthyroidism, no TSH response to TRH stimulation, diffuse thyroid goiter without eye signs or pretibial myxedema). Of interest in this case was the fact that: (a) she is the youngest patient reported with hyperthyroidism due to a TSH-secreting macroadenoma and (b) hyperthyroidism was diagnosed after adenomectomy.
格雷夫斯病、多结节毒性甲状腺肿或毒性腺瘤是儿童及成人甲状腺功能亢进症的常见病因。我们报告一例11岁女孩因分泌促甲状腺激素(TSH)的垂体大腺瘤导致甲状腺功能亢进症的病例。该患者因垂体大腺瘤接受经额部腺瘤切除术及垂体放疗五个月后,入住内分泌科进行垂体功能评估。入院时患者临床诊断为甲状腺功能亢进症,检查确诊为分泌TSH腺瘤所致的甲状腺功能亢进症(甲状腺功能亢进时TSH水平升高,对促甲状腺激素释放激素(TRH)刺激无TSH反应,甲状腺弥漫性肿大,无眼部体征或胫前黏液性水肿)。该病例值得关注的是:(a)她是报道的因分泌TSH的大腺瘤导致甲状腺功能亢进症的最年轻患者;(b)甲状腺功能亢进症在腺瘤切除术后被诊断出来。