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Primary hypothyroidism. Differentiation from primary hypopituitarism.

S Raiti, E Trias, N K Maclaren

    American Journal of Diseases of Children (1960)
    |December 1, 1975
    PubMed
    Summary
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    Growth failure in children can stem from primary hypopituitarism or hypothyroidism. Early diagnosis through endocrinologic testing and levothyroxine treatment is crucial for growth and pubertal development.

    Area of Science:

    • Pediatric Endocrinology
    • Growth Disorders
    • Hormone Therapy

    Background:

    • Growth failure is a common concern in pediatric endocrinology.
    • Distinguishing between hypopituitarism and hypothyroidism can be challenging based on clinical signs alone.
    • Hormone deficiencies can significantly impact growth and development.

    Purpose of the Study:

    • To present cases of children with growth failure and subtle clinical signs.
    • To highlight the diagnostic challenges in differentiating primary hypopituitarism from primary hypothyroidism.
    • To evaluate the efficacy of levothyroxine sodium treatment in these patients.

    Main Methods:

    • Case series presentation of five patients with growth failure.
    • Clinical evaluation and specific endocrinologic testing for diagnosis.

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  • Treatment with levothyroxine sodium and monitoring of growth and pubertal development.

    • Main Results:

    • Two patients diagnosed with primary hypopituitarism, three with primary hypothyroidism.
    • Significant growth acceleration observed: 7.0–12.5 cm (year 1) and 6.2–8.7 cm (year 2) with levothyroxine.
    • Three adolescent patients achieved puberty within 6–9 months of levothyroxine therapy.
    • Associated conditions noted: femoral epiphysial dysgenesis, hypoglycemia, undescended testes, and early-onset diabetes mellitus.

    Conclusions:

    • Specific endocrinologic testing is essential for accurate diagnosis and differentiation.
    • Levothyroxine sodium is effective in promoting growth and pubertal development in these conditions.
    • Early diagnosis and treatment are critical for optimizing outcomes in children with growth failure.