Increased levothyroxine requirements presenting as “inappropriate” TSH secretion syndrome in a patient with nephrotic syndrome

2000 ◽  
Vol 23 (6) ◽  
pp. 383-392 ◽  
Author(s):  
M. T. Collins ◽  
A. T. Remaley ◽  
G. Csako ◽  
F. Pucino ◽  
M. C. Skarulis ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Tsh Secretion ◽  
Inappropriate Tsh Secretion

scholarly journals DIAGNOSIS OF ENDOCRINE DISEASE: Diagnostic approach to TSH-producing pituitary adenoma

2017 ◽  
Vol 177 (4) ◽  
pp. R183-R197 ◽  
Author(s):  
Axel Tjörnstrand ◽  
Helena Filipsson Nyström
Keyword(s):  
Rare Condition ◽  
Diagnostic Approach ◽  
Laboratory Assessment ◽  
Pituitary Mass ◽  
Endocrine Disease ◽  
Clinical Presentations ◽  
Practical Suggestion ◽  
Tsh Secretion ◽  
Diagnostic Approaches ◽  
Inappropriate Tsh Secretion

Thyrotropin (TSH)-secreting adenomas (TSHomas) are the rarest form of pituitary adenomas, and most endocrinologists will see few cases in a lifetime, if any. In most cases, the diagnostic approach is complicated and cases may be referred after being presented as a syndrome of inappropriate TSH secretion or as a pituitary mass. This review aims to cover the past, present and possible future diagnostic approaches to TSHomas, including different clinical presentations, laboratory assessment and imaging advances. The differential diagnoses will be discussed, as well as possible coexisting disorders. By evaluating the existing reports and reviews describing this rare condition, this review aims to present a clinically practical suggestion on the diagnosic workup for TSHomas, Major advances and scientific breakthroughs in the imaging area in recent years, facilitating diagnosis of TSHomas, support the belief that future progress within the imaging field will play an important role in providing methods for a more efficient diagnosis of this rare condition.

scholarly journals Adenoma hipofisário secretor de TSH: uma revisão sistemática / TSH-secreting pituitary adenoma: a systematic review

2020 ◽  
Vol 65 (1) ◽  
pp. 1
Author(s):  
Paulyanara Monique Alves de Souza ◽  
Jefferson Ricardo Rodrigues Morais ◽  
Karla Vanessa Rodrigues Morais ◽  
Josué Da Silva Brito ◽  
Talitha Araújo Faria
Keyword(s):  
Thyroid Hormones ◽  
Pituitary Adenomas ◽  
Case Reports ◽  
Somatostatin Analogs ◽  
Mass Effect ◽  
Pituitary Neoplasms ◽  
Central Hypothyroidism ◽  
First Choice ◽  
Tsh Secretion ◽  
Inappropriate Tsh Secretion

Introdução: Os adenomas hipofisários são tumores caracterizados pela proliferação de células adeno-hipofisárias produtoras de hormônios tróficos. Dentre eles, os adenomas hipofisários produtores de TSH (TSHomas), neoplasias benignas pouco frequentes, que correspondem a menos do que 3% dos adenomas hipofisários. Método: Pesquisamos os termos TSHomas, tireotropinomas e adenomas pituitários secretores de TSH nas bases Pubmed, Lilacs e Scielo. Incluímos artigos publicados entre 2010 e 2020, sendo excluídos relatos de casos, artigos indisponíveis e que não tratavam sobre o tema. Resultados e discussão: Os TSHomas são tumores fibrosos, monoclonais, com incidência entre 0,015 a 0,03 casos/100.000 habitantes, que se manifestam por hipertireoidismo e sintomas causados por efeito de massa. São diagnosticados diante da elevação de TSH juntamente a hormônios tireoidianos, na presença de alterações neurorradiológicas. O tratamento de primeira escolha consiste na neurocirurgia transesfenoidal, sendo os análogos de somatostatina e a radioterapia alternativas para o manejo de pacientes em que a intervenção cirúrgica é desaconselhada. Conclusão: Os TSHomas são raros, contudo, precisam ser investigados diante da secreção inadequada de TSH.Palavras chave: Adenoma, Hormônios tireoidianos, Neoplasias hipofisárias, Síndrome da secreção inadequada de TSH, Hipertireoidismo centralABSTRACTIntroduction: Pituitary adenomas are tumors characterized by the proliferation of adenohypophysis cells that produce trophic hormones. Among them, TSH-producing pituitary adenomas (TSHomas), uncommon benign neoplasms, whichcorrespond to less than 3% of pituitary adenomas. Method: We searched for the terms TSHomas, thyrotropinomas and pituitary adenomas secreting TSH in the Pubmed, Lilacs and Scielo databases. We included articles published between 2010 and 2020, excluding case reports, articles that were unavailable and did not deal with the topic. Results and discussion: TSHomas are fibrous, monoclonal tumors, with an incidence of 0.015 to 0.03 cases / 100,000 inhabitants, which are manifested by hyperthyroidism and symptoms caused by a mass effect. They are diagnosed with elevated TSH along with thyroid hormones, in the presence of neuroradiological changes. The first-choice treatment consists of transsphenoidal neurosurgery, with somatostatin analogs and radiotherapy being alternatives for the management of patients in whom surgical intervention is not recommended. Conclusion: TSHomas are rare, however, they need to be investigated due to inadequate TSH secretion.Keywords: Adenoma, Thyroid hormones, Pituitary neoplasms, Inappropriate TSH secretion syndrome, Central hypothyroidism

Hyperthyroidism due to non-tumoural inappropriate TSH secretion

1986 ◽  
Vol 113 (1) ◽  
pp. 42-46 ◽  
Author(s):  
Gareth Williams ◽  
Marius Kraenzlin ◽  
Laurence Sandier ◽  
Jacky Burrin ◽  
Adam Law ◽  
...  
Keyword(s):  
Pituitary Tumour ◽  
Somatostatin Analogues ◽  
Molar Ratio ◽  
Somatostatin Analogue ◽  
Axial Tomography ◽  
Α Subunit ◽  
Tsh Secretion ◽  
Long Acting ◽  
Inappropriate Tsh Secretion ◽  
Tsh Levels

Abstract. Inappropriate hypersecretion of TSH was investigated in a 25 year old man whose hyperthyroidism had relapsed 4 years after subtotal thyroidectomy. Serum TSH levels were further increased by both TRH and metoclopramide and were partially suppressed by triiodothyronine (120 μ/day). The serum α-subunit: TSH molar ratio was < 1.0, and computerised axial tomography showed no evidence of a pituitary tumour. These features are characteristic of inappropriate TSH secretion due to thyrotroph resistance to thyroid hormones. A long-acting somatostatin analogue (SMS 201-995), 50 μg injected sc twice-daily for three days, suppressed TSH levels and nearly normalised thyroid hormone levels. Somatostatin analogues may be therapeutically useful in thyrotoxicosis due to non-tumoural inappropriate TSH hypersecretion.

scholarly journals FAMILIAL HYPERTHYROIDISM DUE TO INAPPROPRIATE TSH SECRETION: A SEX LINKED DOMINANT TRAIT

1988 ◽  
Vol 23 (1) ◽  
pp. 134-134
Author(s):  
A Roster ◽  
A Kauschansky ◽  
M Frydman ◽  
G Kohn ◽  
J Gross ◽  
...  
Keyword(s):  
Dominant Trait ◽  
Tsh Secretion ◽  
Inappropriate Tsh Secretion

Defective TSH Suppression in a Case of Non-Neoplastic Inappropriate TSH Secretion (ITSHS)

1986 ◽  
pp. 267-270
Author(s):  
Salvatore Benvenga ◽  
Giuseppe A. Sobbrio ◽  
Francesco Vermiglio ◽  
Salvatore Cannavo ◽  
Antonio Granata ◽  
...  
Keyword(s):  
Tsh Suppression ◽  
Tsh Secretion ◽  
Inappropriate Tsh Secretion

Empty Sella Associated with Inappropriate TSH Secretion

1987 ◽  
Vol 18 (01) ◽  
pp. 37-39 ◽  
Author(s):  
W. Hoffman ◽  
B. England ◽  
Lily Gomez ◽  
G. Rosculet ◽  
R. Gala
Keyword(s):  
Empty Sella ◽  
Tsh Secretion ◽  
Inappropriate Tsh Secretion

Mild hyperthyroidism with inappropriate secretion of TSH in postmenopausal women

1986 ◽  
Vol 111 (2) ◽  
pp. 204-208 ◽  
Author(s):  
N. Custro ◽  
V. Scafidi
Keyword(s):  
Thyroid Hormones ◽  
Postmenopausal Women ◽  
Present Report ◽  
Serum Levels ◽  
Suppressive Effect ◽  
Pituitary Thyroid Axis ◽  
Tsh Secretion ◽  
Thyroid Axis ◽  
Suppression Test ◽  
Inappropriate Tsh Secretion

Abstract. In a previous study on the function of the hypothalamus - pituitary - thyroid axis, about 10% of postmenopausal women with the climacteric syndrome were found to have borderline high values of T3 and T4 and signs of pituitary decreased sensitivity to the suppressive effect of increased thyroid hormones. The present report concerns 5 women in the first phase of their menopause who showed a mild hyperthyroidism under basal conditions and after suppression test with liothyronine. Each patient had borderline increased levels of serum total and free T4 and T3 and a marked TSH responsiveness to exogenous TRH. After liothyronine, the serum levels of T4, FT4, TSH and the responsiveness to TRH-test clearly decreased. These data suggest an inappropriate TSH secretion with a decreased pituitary sentitivity to thyroid hormones. These cases could represent a modification of the hypothalamus-pituitary-thyroid axis associated with that of the gonadal axis, secondary to the absence of rapid adaptation of neurotransmitters.

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