MyMedR

Fulltext Pituitary thyroid resistance syndrome

Norlela S, Nor Azmi K, Khalid BAK

Med J Malaysia, 2005 Dec;60(5):642-3.

Thyroid hormone resistance (RTH) is a rare autosomal dominant disorder, characterized clinically by goiter and biochemically by elevated circulating free thyroid hormone levels in the presence of measurable serum thyroid-stimulating hormone (TSH) concentrations. About 85% of patients with RTH harbor mutations in thyroid hormone receptor [beta] (TR[beta]). Even rarer is pituitary thyroid resistance syndrome. We report a case of a 35-year-old man who presented with hypermetabolic symptoms with elevated levels of thyroid hormones, associated with nonsuppressed thyrotropin (TSH). When treated with anti-thyroid drugs, his thyroid hormone levels normalized and TSH increased, suggesting thyroid resistance at the pituitary level.

Matched MeSH terms: Pituitary Diseases/complications*; Pituitary Diseases/diagnosis*; Pituitary Diseases/drug therapy

Intrasellar pituitary mucocele: diagnostic dilemma

Tang IP, Chai CK, Kumar G, Prepageran N, Waran V

Br J Neurosurg, 2014 Jun;28(3):390-2.

PMID: 23875880 DOI: 10.3109/02688697.2013.817535

Isolated intrasellar pituitary mucocele following transsphenoidal sinus surgery is extremely rare. The clinical features resemble a pituitary tumor, therefore careful radiological interpretation is crucial to reach the correct diagnosis. We report a case of intrasellar mucocele who had transsphenoidal sinus surgery performed 15 years prior.

Matched MeSH terms: Pituitary Diseases/diagnosis*; Pituitary Diseases/pathology

Fulltext Contribution of GnIH Research to the Progress of Reproductive Neuroendocrinology

Tsutsui K, Ubuka T, Son YL, Bentley GE, Kriegsfeld LJ

Front Endocrinol (Lausanne), 2015;6:179.

PMID: 26635728 DOI: 10.3389/fendo.2015.00179

Since the discovery of gonadotropin-releasing hormone (GnRH) in mammals at the beginning of the 1970s, it was generally accepted that GnRH is the only hypothalamic neuropeptide regulating gonadotropin release in mammals and other vertebrates. In 2000, however, gonadotropin-inhibitory hormone (GnIH), a novel hypothalamic neuropeptide that actively inhibits gonadotropin release, was discovered in quail. Numerous studies over the past decade and a half have demonstrated that GnIH serves as a key player regulating reproduction across vertebrates, acting on the brain and pituitary to modulate reproductive physiology and behavior. In the latter case, recent evidence indicates that GnIH can regulate reproductive behavior through changes in neurosteroid, such as neuroestrogen, biosynthesis in the brain. This review summarizes the discovery of GnIH, and the contributions to GnIH research focused on its mode of action, regulation of biosynthesis, and how these findings advance our understanding of reproductive neuroendocrinology.

Matched MeSH terms: Pituitary Diseases

Now You See, Now You Don't: A Case Of Spontaneous Regression of Pituitary Tumour

Jaafar AS, Mohd Shokri SS, Paramasvaran S, Palaniandy K, Fadzil F

Cureus, 2020 Jul 14;12(7):e9174.

PMID: 32802610 DOI: 10.7759/cureus.9174

Spontaneous regression of pituitary tumours are rare and can be due to tumour ischaemia, pituitary apoplexy, or lymphocytic hypophysitis. We report a case of a 32-year-old female, who presented with symptoms and signs of extrasellar pituitary enlargement and hypothyroidism. MRI revealed a pituitary mass that spontaneously regressed after a month, with complete resolution of symptoms. Not all pituitary tumours require surgical intervention especially in the case of autoimmune lymphocytic hypophysitis.

Matched MeSH terms: Pituitary Diseases

Fulltext Endocrinological Outcome of Endoscopic Transsphenoidal Surgery for Functioning and Non-Functioning Pituitary Adenoma

Yi LS, Alias A, Ghani ARI, Bidin MBL

Malays J Med Sci, 2019 May;26(3):64-71.

PMID: 31303851 MyJurnal DOI: 10.21315/mjms2019.26.3.5

Introduction: The present study analysed the (i) remission and preservation of hormones, (ii) endocrinological and anatomical complications and (iii) visual improvement after endoscopic transsphenoidal surgery (ETS).

Methods: The retrospective observational study of all consecutive cases of pituitary adenoma treated with ETS in Hospital Kuala Lumpur (HKL) between 2006 and 2015. Age, sex, pre- and post-operative hormone level, tumour size, and complications were noted.

Results: A total of 67 patients were diagnosed with non-functioning pituitary adenoma throughout this period. Of these, 11 patients had both visual and hormonal improvement post-operation. Of the 27 patients with tumour invaded into the cavernous sinus, 13 showed an improved vision. In the adenoma patients who had impaired hormonal function before the surgery, the hormone level normalised post-surgery in 42 patients. Moreover, 39 patients were diagnosed with functioning pituitary adenoma. Ten patients recovered from acromegaly and four patients recovered from Cushing disease within seven days post-operative. Also, five patients with functioning adenoma suffered complications.

Conclusion: Outcome for the preservation and hormone recovery in non-functioning pituitary adenoma group was satisfactory, with only one patient's hormonal level worsening. No visual deterioration and mortality were detected throughout this study. A dedicated team specialised in endoscopic transsphenoidal pituitary surgery further improved the outcome of this surgical method.

Matched MeSH terms: Pituitary Diseases

Evaluation of ACTH reserve in pituitary-hypothalamic disease

De Witt GF, Abdullah F, Eravelly J, Selby R

Med J Malaya, 1966 Jun;20(4):276-80.

PMID: 4288690

Matched MeSH terms: Pituitary Diseases/diagnosis*

Fulltext Idiopathic thrombocytopenic purpura in childhood, Langerhans cell histiocytosis in adulthood: More than a chance association?

Kuan YC, Nurain MN

Med J Malaysia, 2017 02;72(1):50-52.

PMID: 28255140 MyJurnal

Described herein, a case of Langerhans cell histiocytosis (LCH) in an adult with Idiopathic Thrombocytopenic Purpura (ITP) diagnosed at age ten. She presented with cranial diabetes insipidus, later developed hypogonadotrophic hypogonadism and multiple cervical lympadenopathy from which histopathology of excisional biopsy confirmed LCH. Magnetic resonance imaging showed thickened pituitary stalk. Association of ITP and LCH is unknown but the question of LCH presenting as isolated thrombocytopenia in childhood only to be discovered in adulthood when there was pituitary and bone involvement remains. It reemphasizes the need for high index of suspicion and the challenges in diagnosing LCH at the outset.

Matched MeSH terms: Pituitary Diseases

Fulltext 'Houdini's Pituitary:' A Case Report of Regression of Pituitary Mass to Empty Sella in a 58-Year-Old Man with Autoimmune Hypophysitis

Ooi CP, Kamarruddin NA, Mustafa N, Kew TY

J ASEAN Fed Endocr Soc, 2018;33(1):69-73.

PMID: 33442114 DOI: 10.15605/jafes.033.01.12

A 58-year-old male presented with persistent severe headache, lethargy, decline libido and no neurological deficits. Besides quadruple anterior pituitary hormonal deficiencies, magnetic resonance imaging (MRI) demonstrated an enlarged ring-enhanced non-homogenous pituitary. Following hormonal replacement, these symptoms improved but empty sella evolved. The challenges of diagnosis and management were discussed. Awareness of the unclear etiology and uncertain clinical course of autoimmune hypophysitis in a man in this age group is essential for prompt and appropriate management.

Matched MeSH terms: Pituitary Diseases

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