原发性甲状腺功能减退致垂体增生两例报告及文献复习

目的:探讨原发性甲状腺功能减退致垂体增生的临床特点、发病机制、诊断和处理原则。方法:结合文献回顾性分析2例原发性甲状腺功能减退致垂体增生的临床资料。结果:2例均表现为促甲状腺激素(TSH)及泌乳素(PRL)增高,FT3及FT4减少,MRI示垂体增大,甲状腺素替代治疗6个月后,垂体体积恢复正常,内分泌检查亦恢复正常。结论:原发性甲状腺功能减退致垂体增生具有影像学特征,结合患者的临床症状、病史及内分泌检查可明确诊断。治疗首选甲状腺素替代治疗,而不宜行手术治疗。

Pituitary hyperplasia secondary to primary hypothyroidism: Report of 2 cases with literature review

Objective:To investigate the clinical picture,mechanisms,diagnosis and management of pituitary hyperplasia secondary to primary hypothyroidism.Methods: The clinical data were retrospectively examined in two cases of pituitary hyperplasia resulting from primary hypothyroidism with literature review.Results: The clinical behavior for the two cases were elevated thyroid stimulating hormone(TSH) and prolactin(PRL),reduced levels of free tri-iodothyronine(FT3) and free thyroxine(FT4) and enlarged pituitary gland on MRI image.By six months of the replacement therapy with thyroxine,the pituitary gland recovered normally and hypothyroidism disappeared on laboratory endocrine examination.Conclusion: Pituitary hyperplasia secondary to primary hypothyroidism bears certain properties on MR image.Conclusive diagnosis of this entity may rely on the clinical symptoms,medical history and endocrine examination,and the first line therapy should be thytoxine substitution instead of surgical intervention.