Kocova Mirjana, Zdraveska Nikolina, Kacarska Rozana, Kochova Elena
J Pediatr Endocrinol Metab. 2016 Mar;29(3):297-303. doi: 10.1515/jpem-2015-0157.
Pituitary hyperplasia secondary to primary longstanding hypothyroidism has been reported in the literature in adults and rarely in children.
Here we present the clinical presentation and diagnostic procedures in eight children with pituitary hyperplasia due to autoimmune thyroiditis, highlighting common findings, such as growth delay, fatigue or gaining weight, but also exceptional findings such as pericardial effusion, rhabdomyolysis, isolated hypertrichosis, and Van Wyk-Grumbach syndrome, which have rarely or never been described.
Surprisingly no thyroid enlargement was detected. We discuss the unusual presenting signs of autoimmune thyroiditis that should raise the suspicion of pituitary hyperplasia. We suggest that a more elaborate clinical assessment and even modification of the diagnostic approach to autoimmune thyroiditis is needed in order to avoid its serious complications.
文献报道了成人原发性长期甲状腺功能减退继发垂体增生，儿童中则罕见。
本文介绍了8例因自身免疫性甲状腺炎导致垂体增生的儿童的临床表现及诊断过程，重点强调了常见表现，如生长发育迟缓、疲劳或体重增加，同时也提及了罕见或从未被描述过的特殊表现，如心包积液、横纹肌溶解、单纯性多毛症和范怀克-格伦巴赫综合征。
令人惊讶的是，未检测到甲状腺肿大。我们讨论了自身免疫性甲状腺炎的异常表现体征，这些体征应引起对垂体增生的怀疑。我们建议，为避免严重并发症，需要进行更详尽的临床评估，甚至调整自身免疫性甲状腺炎的诊断方法。
