Liu Minghua, Hu Yanyan, Li Guimei, Hu Wenwen
Department of Pediatrics, Shandong Provincial Hospital Affiliated to Shandong University, 9677 Jingshi Road, Jinan, Shandong 250014, China ; Department of Child Health Care, Shandong Maternal and Child Health Care Hospital, 238 Jingshi East Road, Jinan, Shandong 250014, China.
Department of Pediatrics, Shandong Provincial Hospital Affiliated to Shandong University, 9677 Jingshi Road, Jinan, Shandong 250014, China.
Int J Endocrinol. 2015;2015:283492. doi: 10.1155/2015/283492. Epub 2015 Sep 2.
Objective. The follow-up of GH levels in short-stature children with pituitary hyperplasia secondary to primary hypothyroidism (PPH) is reported in a few cases. We aimed to observe changes in GH secretion in short-stature children with PPH. Methods. A total of 11 short-stature children with PPH accompanied by low GH levels were included. They received levothyroxine therapy after diagnosis. Their thyroid hormones, IGF-1, PRL, and pituitary height were measured at baseline and 3 months after therapy. GH stimulation tests were performed at baseline and after regression of thyroid hormones and pituitary. Results. At baseline, they had decreased GH peak and FT3 and FT4 levels and elevated TSH levels. Decreased IGF-1 levels were found in seven children. Elevated PRL levels and positive thyroid antibodies were found in 10 children. The mean pituitary height was 14.3 ± 3.8 mm. After 3 months, FT3, FT4, and IGF-1 levels were significantly increased (all p < 0.01), and values of TSH, PRL, and pituitary height were significantly decreased (all p < 0.001). After 6 months, pituitary hyperplasia completely regressed. GH levels returned to normal in nine children and were still low in two children. Conclusion. GH secretion can be resolved in most short-stature children with PPH.
目的。少数病例报告了原发性甲状腺功能减退继发垂体增生（PPH）的身材矮小儿童生长激素（GH）水平的随访情况。我们旨在观察PPH身材矮小儿童GH分泌的变化。方法。共纳入11例伴有低GH水平的PPH身材矮小儿童。诊断后给予左甲状腺素治疗。在基线和治疗3个月后测量他们的甲状腺激素、胰岛素样生长因子-1（IGF-1）、催乳素（PRL）和垂体高度。在基线以及甲状腺激素和垂体恢复正常后进行GH刺激试验。结果。基线时，他们的GH峰值、游离三碘甲状腺原氨酸（FT3）和游离甲状腺素（FT4）水平降低，促甲状腺激素（TSH）水平升高。7名儿童的IGF-1水平降低。10名儿童的PRL水平升高且甲状腺抗体呈阳性。垂体平均高度为14.3±3.8毫米。3个月后，FT3、FT4和IGF-1水平显著升高（均p<0.01），TSH、PRL和垂体高度值显著降低（均p<0.001）。6个月后，垂体增生完全消退。9名儿童的GH水平恢复正常，2名儿童的GH水平仍低。结论。大多数PPH身材矮小儿童的GH分泌可得到改善。
