Case Report: A patient with an empty sella accompanied by rare thyrotoxicosis

Empty sella (ES) involves herniation of the pituitary fossa, leading to pituitary flattening. While typically associated with central hypothyroidism, its co-occurrence with hyperthyroidism is rarely reported and often overlooked. We report a rare case of hyperthyroidism in a patient with ES. The pat...

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Main Authors: Zhaoyang Li, Kangning Han, Wenhui Yang, Bo Wu, Rufan Cao, Shiyao Chen, Xinyu Zhang, Xiaochun Han, Liangqing Guo
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1516538/full
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author Zhaoyang Li
Kangning Han
Wenhui Yang
Bo Wu
Rufan Cao
Shiyao Chen
Xinyu Zhang
Xiaochun Han
Liangqing Guo
author_facet Zhaoyang Li
Kangning Han
Wenhui Yang
Bo Wu
Rufan Cao
Shiyao Chen
Xinyu Zhang
Xiaochun Han
Liangqing Guo
author_sort Zhaoyang Li
collection DOAJ
description Empty sella (ES) involves herniation of the pituitary fossa, leading to pituitary flattening. While typically associated with central hypothyroidism, its co-occurrence with hyperthyroidism is rarely reported and often overlooked. We report a rare case of hyperthyroidism in a patient with ES. The patient was diagnosed with ES combined with Graves’ disease (GD) and Hashimoto’s thyroiditis (HT). Her pituitary gland appeared flattened with a depressed upper edge. The gland height was approximately 2.3 mm. Abnormal thyroid function in this case may result from the combined effects of all three conditions. A literature search on PubMed revealed a possible association between ES and autoimmune thyroid disease; however, only seven relevant studies were identified, and no standardized diagnostic or treatment protocols exist. Hyperthyroidism may mask the diagnosis of ES. In patients whose thyroid function does not normalize with conventional oral antithyroid medication, the possibility of ES should be considered. When ES is associated with primary hyperthyroidism, antithyroid drug dosages should be lower than conventional doses. Thyroid function should be monitored more frequently, and medication dosages should be adjusted promptly.
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institution Kabale University
issn 1664-2392
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publishDate 2025-08-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Endocrinology
spelling doaj-art-91ddb6b6b7394d3a9ac9b935f3764cb72025-08-20T04:14:11ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-08-011610.3389/fendo.2025.15165381516538Case Report: A patient with an empty sella accompanied by rare thyrotoxicosisZhaoyang Li0Kangning Han1Wenhui Yang2Bo Wu3Rufan Cao4Shiyao Chen5Xinyu Zhang6Xiaochun Han7Liangqing Guo8The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, ChinaThe First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, ChinaThe First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, ChinaDepartment of Cardiovascular, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, ChinaThe First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, ChinaCollege of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, ChinaThe First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, ChinaCollege of Health, Shandong University of Traditional Chinese Medicine, Jinan, ChinaDepartment of Endocrinology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, ChinaEmpty sella (ES) involves herniation of the pituitary fossa, leading to pituitary flattening. While typically associated with central hypothyroidism, its co-occurrence with hyperthyroidism is rarely reported and often overlooked. We report a rare case of hyperthyroidism in a patient with ES. The patient was diagnosed with ES combined with Graves’ disease (GD) and Hashimoto’s thyroiditis (HT). Her pituitary gland appeared flattened with a depressed upper edge. The gland height was approximately 2.3 mm. Abnormal thyroid function in this case may result from the combined effects of all three conditions. A literature search on PubMed revealed a possible association between ES and autoimmune thyroid disease; however, only seven relevant studies were identified, and no standardized diagnostic or treatment protocols exist. Hyperthyroidism may mask the diagnosis of ES. In patients whose thyroid function does not normalize with conventional oral antithyroid medication, the possibility of ES should be considered. When ES is associated with primary hyperthyroidism, antithyroid drug dosages should be lower than conventional doses. Thyroid function should be monitored more frequently, and medication dosages should be adjusted promptly.https://www.frontiersin.org/articles/10.3389/fendo.2025.1516538/fullempty sellaGraves’ diseaseHashimoto thyroiditiscase reportautoimmune thyroid disease (AITD)
spellingShingle Zhaoyang Li
Kangning Han
Wenhui Yang
Bo Wu
Rufan Cao
Shiyao Chen
Xinyu Zhang
Xiaochun Han
Liangqing Guo
Case Report: A patient with an empty sella accompanied by rare thyrotoxicosis
Frontiers in Endocrinology
empty sella
Graves’ disease
Hashimoto thyroiditis
case report
autoimmune thyroid disease (AITD)
title Case Report: A patient with an empty sella accompanied by rare thyrotoxicosis
title_full Case Report: A patient with an empty sella accompanied by rare thyrotoxicosis
title_fullStr Case Report: A patient with an empty sella accompanied by rare thyrotoxicosis
title_full_unstemmed Case Report: A patient with an empty sella accompanied by rare thyrotoxicosis
title_short Case Report: A patient with an empty sella accompanied by rare thyrotoxicosis
title_sort case report a patient with an empty sella accompanied by rare thyrotoxicosis
topic empty sella
Graves’ disease
Hashimoto thyroiditis
case report
autoimmune thyroid disease (AITD)
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1516538/full
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