Hermus A, Ross H, van Liessum P, Naber A, Smals A, Kloppenborg P
Department of Medicine, St. Radboud University Hospital, Nijmegen, The Netherlands.
Neth J Med. 1991 Jun;38(5-6):193-8.
The case histories of three patients with hyperthyroidism due to overproduction of thyroid-stimulating hormone (TSH) by the pituitary gland are described. In the first patient treatment with the T3-metabolite 3,5,3'-triiodothyroacetic acid (TRIAC) led to complete clinical and biochemical normalization. In the second patient treatment with the dopaminergic agonist bromocriptine led to a temporal amelioration of hyperthyroidism. In the third patient, who was the only one with a proven pituitary adenoma, hypersecretion of TSH could be controlled by administration of the somatostatin analogue octreotide. It is emphasized that patients with this disorder should preferably not be treated with thyrostatic drugs, radioactive iodine or thyroid surgery. The success rate of these treatment modalities is lower than normal, they may lead to an increase of goiter size, and they potentially may promote growth or development of a TSH-producing adenoma. Treatment should be aimed at diminishing TSH hypersecretion.
本文描述了3例因垂体过度分泌促甲状腺激素（TSH）导致甲状腺功能亢进的患者的病历。在首例患者中，使用T3代谢物3,5,3'-三碘甲状腺乙酸（TRIAC）治疗后，临床和生化指标完全恢复正常。在第二例患者中，使用多巴胺能激动剂溴隐亭治疗使甲状腺功能亢进得到暂时改善。在第三例患者中，他是唯一经证实患有垂体腺瘤的患者，使用生长抑素类似物奥曲肽可控制TSH的过度分泌。需要强调的是，患有这种疾病的患者最好不要使用抗甲状腺药物、放射性碘或甲状腺手术进行治疗。这些治疗方式的成功率低于正常水平，可能会导致甲状腺肿大，并且有可能促进分泌TSH的腺瘤生长或发展。治疗应旨在减少TSH的过度分泌。
