Lecky B R, Williams T D, Lightman S L, Plant G T, Stevens J
Lancet. 1987 Jun 13;1(8546):1347-50. doi: 10.1016/s0140-6736(87)90651-9.
A 60-year-old woman presented with deteriorating vision. A computed tomography (CT) scan showed pituitary enlargement with chiasmal compression. Serum prolactin levels were normal but assessment of thyroid function showed a serum thyroxine level of 25 nmol/l (normal range 76-160 nmol/l) and a thyroid-stimulating hormone (TSH) level of 60 mU/l (normal range 0.5-5.0 mU/l). After 8 weeks of thyroxine replacement therapy (0.05 mg daily increasing to 0.1 mg daily after 3 weeks) the visual defects had resolved, serum TSH had fallen to 0.7 mU/l, and the CT scan showed pronounced reduction in the size of the pituitary gland. Measurement of TSH as well as prolactin is essential in all patients with pituitary enlargement, to avoid unnecessary pituitary surgery.
一名60岁女性因视力下降就诊。计算机断层扫描（CT）显示垂体增大并压迫视交叉。血清催乳素水平正常，但甲状腺功能评估显示血清甲状腺素水平为25 nmol/l（正常范围76 - 160 nmol/l），促甲状腺激素（TSH）水平为60 mU/l（正常范围0.5 - 5.0 mU/l）。经过8周的甲状腺素替代治疗（开始每日0.05 mg，3周后增至每日0.1 mg），视力缺陷消失，血清TSH降至0.7 mU/l，CT扫描显示垂体大小明显缩小。对于所有垂体增大的患者，检测TSH以及催乳素至关重要，以避免不必要的垂体手术。
