Otsuka F, Ogura T, Hayakawa N, Hashimoto M, Makino H, Ota Z, Kageyama J
Third Department of Internal Medicine, Okayama University Medical School, Japan.
Endocr J. 1996 Oct;43(5):495-502. doi: 10.1507/endocrj.43.495.
Schmidt syndrome consists of adrenal insufficiency and Hashimoto's thyroiditis, which are probably caused by an autoimmune process. We encountered a patient who manifested severe generalized fatigue due to Schmidt syndrome recurrently. The endocrinological examination tests on the patient showed that the increase in thyroid stimulating hormone (TSH) and ACTH concentrations were not remarkable, despite hypo-function of the peripheral glands. Subsequent cranial magnetic resonance imaging (MRI) exhibited the existence of a pituitary tumor. The pathological findings on the resected tumor and endocrinological stimulation tests proved that the tumor was a FSH-producing adenoma. Although involvement of the pituitary region in Schmidt syndrome on rare occasions presents as hypophysitis, no pituitary adenoma has previously been reported in association with this syndrome. We present a patient with Schmidt syndrome and an accompanying FSH-producing pituitary adenoma. The coexistence of these disorders suggests that the functioning pituitary tumor might be considered as a pituitary lesion in Schmidt syndrome.
施密特综合征由肾上腺功能不全和桥本甲状腺炎组成，可能由自身免疫过程引起。我们遇到了一名因施密特综合征反复出现严重全身疲劳的患者。对该患者进行的内分泌检查显示，尽管外周腺体功能减退，但促甲状腺激素（TSH）和促肾上腺皮质激素（ACTH）浓度升高并不显著。随后的头颅磁共振成像（MRI）显示存在垂体肿瘤。切除肿瘤的病理结果和内分泌刺激试验证明该肿瘤是分泌促卵泡激素（FSH）的腺瘤。虽然施密特综合征累及垂体区域在极少数情况下表现为垂体炎，但此前尚无垂体腺瘤与该综合征相关的报道。我们报告了一名患有施密特综合征及伴发分泌FSH的垂体腺瘤的患者。这些疾病的共存提示，功能性垂体肿瘤可能被视为施密特综合征中的垂体病变。
