Abs R, Stevenaert A, Beckers A
Department of Endocrinology, University of Antwerp, Belgium.
Eur J Endocrinol. 1994 Oct;131(4):355-8. doi: 10.1530/eje.0.1310355.
A 51-year-old female patient with long-standing hyperthyroidism due to a thyrotropin-secreting pituitary adenoma is reported, who became thyrotoxic again shortly after successful pituitary surgery. Functional testing and scintigraphy suggested the diagnosis of autonomous functioning thyroid nodules, which was confirmed by pathological examination of the resected thyroid tissue. This is the first report revealing the transition from a pituitary-dependent to a thyroid-dependent hyperthyroidism. Autonomous functioning thyroid nodules are, however, considered an intrinsic thyroid defect. In similarity with other disorders, in which trophic hormones may induce an autonomous secretion by the target gland, this report opens the possibility that a humoral factor may play a role in the development of autonomous functioning thyroid nodules.
报告了一名51岁的女性患者，因促甲状腺素分泌型垂体腺瘤长期患有甲状腺功能亢进，在垂体手术成功后不久再次出现甲状腺毒症。功能测试和闪烁扫描提示诊断为自主性功能性甲状腺结节，切除的甲状腺组织病理检查证实了这一诊断。这是首次报道从垂体依赖性甲状腺功能亢进转变为甲状腺依赖性甲状腺功能亢进。然而，自主性功能性甲状腺结节被认为是一种甲状腺内在缺陷。与其他一些疾病类似，在这些疾病中，促激素可能诱导靶腺自主分泌，本报告提出了一种可能性即一种体液因子可能在自主性功能性甲状腺结节的发生中起作用。
