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HYPERTHYROIDISM DUE TO A PITUITARY TSH SECRETING TUMOUR WITH AMENORRHOEA‐GALACTORRHOEA
Author(s) -
BENOIT R.,
PEARSONMURPHY B. E.,
ROBERT F.,
MARCOVITZ S.,
HARDY J.,
TSOUKAS G.,
GARDINER† R. J.
Publication year - 1980
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.1980.tb03127.x
Subject(s) - bromocriptine , medicine , endocrinology , prolactin , thyrotropic cell , trh stimulation test , somatostatin , amenorrhea , pituitary gland , thyrotropin releasing hormone , gonadotropic cell , pregnancy , hormone , biology , genetics
SUMMARY A 20–year‐old female presented with thyrotoxicosis associated with amenorrhoea and galactorrhoea after oral contraceptive withdrawal. Serum TSH was persistently elevated (mean: 28 ± 31 μU/ml during 24–h sampling and did not vary significantly after TRH, bromocriptine or somatostatin. Prolactin levels remained constantly at the upper limit of normal (mean: 206 ± 21 ng/ml, with a minimal increase after TRH, a slight decrease after somatostatin (54%) and a marked decrease after bromocriptine (885%). Surgical exploration revealed an unusually firm tumour adherant to the wall of the sella turcica; electron microscopic study showed that it was composed almost exclusively of thyrotrophs. After a transient period of euthyroidism post‐operatively, T3 toxicosis occurred with an increased TSH level (155 μU/ml) and a rise in TSH and alpha subunit in response to TRH. An increase in T4 followed while prolactin remained low.