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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Frontiers Media S.A.
2025-08-01
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| 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. |
| format | Article |
| id | doaj-art-91ddb6b6b7394d3a9ac9b935f3764cb7 |
| institution | Kabale University |
| issn | 1664-2392 |
| language | English |
| 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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