Pituitary Macroadenoma and Severe Hypothyroidism: The Link between Brain Imaging and Thyroid Function
In case of primary hypothyroidism, reactive pituitary hyperplasia can manifest as pituitary (pseudo) macroadenoma. We report the case of a 12-year-old boy who was evaluated for impaired growth velocity and increased body weight. Because of low insulin-like growth factor 1 levels and poor response to...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Case Reports in Pediatrics |
| Online Access: | http://dx.doi.org/10.1155/2021/2360855 |
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| author | Silvia Ciancia Silvia Cesari Barbara Predieri Sergio Bernasconi Lorenzo Iughetti |
| author_facet | Silvia Ciancia Silvia Cesari Barbara Predieri Sergio Bernasconi Lorenzo Iughetti |
| author_sort | Silvia Ciancia |
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| description | In case of primary hypothyroidism, reactive pituitary hyperplasia can manifest as pituitary (pseudo) macroadenoma. We report the case of a 12-year-old boy who was evaluated for impaired growth velocity and increased body weight. Because of low insulin-like growth factor 1 levels and poor response to the growth hormone stimulation test, brain magnetic resonance imaging was performed and a pituitary macroadenoma was found. Treatment with levothyroxine was started, and thyroid function was evaluated approximately every 40 days to titrate the dosage. After few months of therapy, the size of the macroadenoma decreased and growth hormone secretion normalized. The pituitary returned to normal size in approximately 5 years. The boy went through puberty spontaneously and reached a normal adult height. In a patient affected by primary hypothyroidism, reactive pituitary hyperplasia can cause growth hormone deficiency; however, growth hormone secretion usually normalizes after starting levothyroxine treatment. Pituitary macroadenoma can be difficult to distinguish from severe pituitary hyperplasia; however, pituitary macroadenomas are rare in childhood, and our clinical case underlines how the hormonal evaluation is essential to achieve a correct diagnosis and prevent unnecessary surgery in a context of pituitary mass. |
| format | Article |
| id | doaj-art-4e50ec234bf94bb5b384086dd35778c4 |
| institution | Kabale University |
| issn | 2090-6803 2090-6811 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pediatrics |
| spelling | doaj-art-4e50ec234bf94bb5b384086dd35778c42025-02-03T05:47:38ZengWileyCase Reports in Pediatrics2090-68032090-68112021-01-01202110.1155/2021/23608552360855Pituitary Macroadenoma and Severe Hypothyroidism: The Link between Brain Imaging and Thyroid FunctionSilvia Ciancia0Silvia Cesari1Barbara Predieri2Sergio Bernasconi3Lorenzo Iughetti4Department of Medical and Surgical Sciences of the Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, ItalyFamily Pediatrician, Parma, ItalyDepartment of Medical and Surgical Sciences of the Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, ItalyMicrobiome Research Hub, University of Parma, ItalyDepartment of Medical and Surgical Sciences of the Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, ItalyIn case of primary hypothyroidism, reactive pituitary hyperplasia can manifest as pituitary (pseudo) macroadenoma. We report the case of a 12-year-old boy who was evaluated for impaired growth velocity and increased body weight. Because of low insulin-like growth factor 1 levels and poor response to the growth hormone stimulation test, brain magnetic resonance imaging was performed and a pituitary macroadenoma was found. Treatment with levothyroxine was started, and thyroid function was evaluated approximately every 40 days to titrate the dosage. After few months of therapy, the size of the macroadenoma decreased and growth hormone secretion normalized. The pituitary returned to normal size in approximately 5 years. The boy went through puberty spontaneously and reached a normal adult height. In a patient affected by primary hypothyroidism, reactive pituitary hyperplasia can cause growth hormone deficiency; however, growth hormone secretion usually normalizes after starting levothyroxine treatment. Pituitary macroadenoma can be difficult to distinguish from severe pituitary hyperplasia; however, pituitary macroadenomas are rare in childhood, and our clinical case underlines how the hormonal evaluation is essential to achieve a correct diagnosis and prevent unnecessary surgery in a context of pituitary mass.http://dx.doi.org/10.1155/2021/2360855 |
| spellingShingle | Silvia Ciancia Silvia Cesari Barbara Predieri Sergio Bernasconi Lorenzo Iughetti Pituitary Macroadenoma and Severe Hypothyroidism: The Link between Brain Imaging and Thyroid Function Case Reports in Pediatrics |
| title | Pituitary Macroadenoma and Severe Hypothyroidism: The Link between Brain Imaging and Thyroid Function |
| title_full | Pituitary Macroadenoma and Severe Hypothyroidism: The Link between Brain Imaging and Thyroid Function |
| title_fullStr | Pituitary Macroadenoma and Severe Hypothyroidism: The Link between Brain Imaging and Thyroid Function |
| title_full_unstemmed | Pituitary Macroadenoma and Severe Hypothyroidism: The Link between Brain Imaging and Thyroid Function |
| title_short | Pituitary Macroadenoma and Severe Hypothyroidism: The Link between Brain Imaging and Thyroid Function |
| title_sort | pituitary macroadenoma and severe hypothyroidism the link between brain imaging and thyroid function |
| url | http://dx.doi.org/10.1155/2021/2360855 |
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