Alves Crésio, Alves Ana Cláudia
Pediatric Endocrinology, Faculty of Medicine, Universidade Federal da Bahia, Rua Plinio Moscoso, 222/601, CEP: 40157-190, Salvador, Bahia, Brazil.
Childs Nerv Syst. 2008 Dec;24(12):1505-8. doi: 10.1007/s00381-008-0689-2. Epub 2008 Aug 9.
To report a case of primary hypothyroidism associated to hyperprolactinemia mimicking a prolactin secreting adenoma.
A girl (10 years and 10 months old) was evaluated for hyperprolactinemia (prolactin: 317 ng/mL [1.9-25]). Diagnostic evaluation demonstrated free thyroxine (F-T4): 0.22 ng/dL (0.75-1.80) and thyroid-stimulating hormone (TSH): 135 UI/mL (0.3-5.0). Pituitary magnetic resonance imaging (MRI) showed an intrasellar and suprasellar mass measuring 1.9 x 1.7 x 1.7 cm, impinging on the optic chiasm. Due to the possibility of a pseudoprolactinoma caused by hyperplasia of the TSH and prolactin-producing cells, she was treated for the primary hypothyroidism with levothyroxine. After 2 months, F-T4, TSH, and prolactin returned to normal values. A new pituitary MRI, 8 months later, demonstrated a complete resolution of the pituitary mass confirming the initial suspicion of thyrotroph hyperplasia.
This paper illustrates the importance of thyroid function investigation in patients with hyperprolactinemia and possible prolactinoma in order to avoid unnecessary surgery.
报告一例原发性甲状腺功能减退症合并高催乳素血症，临床表现类似催乳素分泌性腺瘤的病例。
对一名10岁10个月大的女孩进行高催乳素血症评估（催乳素：317 ng/mL[1.9 - 25]）。诊断性检查显示游离甲状腺素（F - T4）：0.22 ng/dL（0.75 - 1.80），促甲状腺激素（TSH）：135 UI/mL（0.3 - 5.0）。垂体磁共振成像（MRI）显示鞍内和鞍上有一个大小为1.9×1.7×1.7 cm的肿块，压迫视交叉。由于存在促甲状腺激素和催乳素分泌细胞增生导致假性催乳素瘤的可能性，对她进行了左甲状腺素治疗原发性甲状腺功能减退症。2个月后，F - T4、TSH和催乳素恢复到正常水平。8个月后进行的新垂体MRI显示垂体肿块完全消退，证实了最初对促甲状腺激素细胞增生的怀疑。
本文阐述了对高催乳素血症和可能患有催乳素瘤的患者进行甲状腺功能检查的重要性，以避免不必要的手术。
