Department of Medical Sciences, University of Milan, Italy.
Ann Endocrinol (Paris). 2012 Apr;73(2):138-40. doi: 10.1016/j.ando.2012.04.004. Epub 2012 Apr 26.
The acquired thyrotropic deficiency (TD) is a hypothyroid condition due to an insufficient stimulation by thyrotropin (TSH) of an otherwise normal thyroid gland. This disease can be the consequence of disorders affecting either the pituitary gland or the hypothalamus, but most frequently both of them, and is generally called central hypothyroidism (CH). CH is about one thousand folds rarer than primary hypothyroidism (PH) and the thyroid hormone defect is often less severe than in primary forms. Differently to PH, the TD is most frequently characterized by low/normal TSH levels and thyroid hormone replacement is associated with the suppression of residual TSH secretion. Thus, CH diagnosis and management often represent a clinical challenge because physicians cannot rely on the systematic use of the reflex TSH determination. The clinical challenge of CH is further amplified by the frequent combination with other pituitary deficiencies.
获得性促甲状腺激素缺乏症（TD）是一种由于促甲状腺激素（TSH）对正常甲状腺的刺激不足而导致的甲状腺功能减退症。这种疾病可能是影响垂体或下丘脑的疾病的结果，但最常见的是两者同时受到影响，通常称为中枢性甲状腺功能减退症（CH）。CH 比原发性甲状腺功能减退症（PH）罕见一千倍，甲状腺激素缺乏通常比原发性形式轻。与 PH 不同，TD 最常见的特征是 TSH 水平低/正常，甲状腺激素替代治疗与抑制残余 TSH 分泌有关。因此，CH 的诊断和管理常常是一个临床挑战，因为医生不能依赖于系统使用反射 TSH 测定。CH 的临床挑战因经常与其他垂体功能减退症合并而进一步加剧。
