Document Detail

Thyrotropin-producing microadenoma associated with pituitary resistance to thyroid hormone.
MedLine Citation:
PMID:  8473377     Owner:  NLM     Status:  MEDLINE    
A 21-yr-old female with hyperthyroidism is described. Though her serum-free T3 was 17.8 pmol/L and free T4 was 60.2 pmol/L, TSH was as high as 10.7 mU/L. TRH stimulated an increase in TSH from 10.7-91.7 mU/L. T3 administration in gradually increasing doses of 100, 200, and 400 mg/day resulted in gradual reduction in serum TSH. Cranial computed tomography and magnetic resonance imaging revealed a microadenoma of the pituitary gland. Histology of the surgical specimen showed a TSH-producing adenoma with TSH cell cluster islets and decreased numbers of TSH cells in the nonneoplastic pituitary. Cultured cells from the adenoma secreted TSH spontaneously and in response to TRH. This TRH-stimulated TSH secretion was suppressed by T3 in a dose-dependent manner. One year postoperatively, neither residual tumor nor recurrence were seen by computed tomography and magnetic resonance imaging. However TSH, as well as free T3 or T4, was still high and overresponsive to TRH.
K Watanabe; T Kameya; A Yamauchi; N Yamamoto; A Kuwayama; I Takei; H Maruyama; T Saruta
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  76     ISSN:  0021-972X     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  1993 Apr 
Date Detail:
Created Date:  1993-05-18     Completed Date:  1993-05-18     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1025-30     Citation Subset:  AIM; IM    
Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
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MeSH Terms
Adenoma / diagnosis,  metabolism*,  pathology
Drug Resistance
Magnetic Resonance Imaging
Microscopy, Electron
Pituitary Gland / drug effects*,  surgery
Pituitary Neoplasms / diagnosis,  metabolism*,  pathology
Postoperative Period
Thyroid Gland / pathology,  radiography
Thyroid Hormones / pharmacology*
Thyrotropin / biosynthesis*,  metabolism
Thyrotropin-Releasing Hormone / pharmacology
Tomography, X-Ray Computed
Triiodothyronine / pharmacology
Reg. No./Substance:
0/Thyroid Hormones; 24305-27-9/Thyrotropin-Releasing Hormone; 6893-02-3/Triiodothyronine; 9002-71-5/Thyrotropin

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