Valenta L J, Tamkin J, Sostrin R, Elias A N, Eisenberg H
Fertil Steril. 1983 Sep;40(3):389-92. doi: 10.1016/s0015-0282(16)47307-3.
Two patients are described who were suffering from primary hypothyroidism and who developed a pituitary microadenoma and macroadenoma with suprasellar extension, respectively, diagnosed by CT scan of the pituitary. Both patients originally presented with amenorrhea and galactorrhea. In addition to low serum T4 and T3 levels and an elevated TSH level, they also had hyperprolactinemia. The TRH test performed in one of the patients showed an exaggerated response of both TSH and PRL to TRH. Correction of hypothyroidism by prolonged (months) treatment with levothyroxine resulted in normalization of thyroid function tests as well as hyperprolactinemia and in regression of the pituitary tumor. It was concluded that primary hypothyroidism was the cause of the pituitary adenoma and the amenorrhea/galactorrhea syndrome. It is recommended that routine thyroid function tests be obtained for patients with hyperprolactinemia. Demonstrable primary hypothyroidism should be corrected for prolonged periods of time by levothyroxine therapy, and CT scanning of the pituitary should be repeated before any other treatment such as bromocriptine or surgery is attempted.
本文描述了两名患有原发性甲状腺功能减退症的患者，他们分别发展为垂体微腺瘤和伴有鞍上扩展的大腺瘤，通过垂体CT扫描确诊。两名患者最初均表现为闭经和溢乳。除血清T4和T3水平降低以及TSH水平升高外，他们还患有高泌乳素血症。其中一名患者进行的TRH试验显示，TSH和PRL对TRH的反应均过度。通过左甲状腺素长期（数月）治疗纠正甲状腺功能减退症后，甲状腺功能检查以及高泌乳素血症恢复正常，垂体肿瘤消退。得出的结论是，原发性甲状腺功能减退症是垂体腺瘤和闭经/溢乳综合征的病因。建议对高泌乳素血症患者进行常规甲状腺功能检查。对于可证实的原发性甲状腺功能减退症，应通过左甲状腺素治疗长期纠正，并且在尝试任何其他治疗（如溴隐亭或手术）之前，应重复进行垂体CT扫描。
