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Related Experiment Videos

The pituitary gland in hyperthyroidism.

B W Scheithauer1, K T Kovacs, W F Young

  • 1Section of Surgical Pathology, St. Michael's Hospital, Toronto, Ontario, Canada.

Mayo Clinic Proceedings
|January 11, 1992
PubMed
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Thyrotoxicosis, including Graves' disease, causes a loss of thyrotropin (thyroid-stimulating hormone) in the pituitary gland. This change is reversible with treatment, indicating pituitary adaptation to thyroid dysfunction.

Area of Science:

  • Endocrinology
  • Pathology
  • Immunohistochemistry

Background:

  • Thyrotoxicosis, a condition of excess thyroid hormones, affects multiple organ systems.
  • The pituitary gland plays a crucial role in regulating thyroid function via thyrotropin (TSH).
  • Histological and immunocytochemical changes in the pituitary during thyrotoxicosis are not fully understood.

Purpose of the Study:

  • To investigate pituitary gland histology and hormone expression in patients who died from thyrotoxicosis.
  • To identify specific changes in pituitary cells, particularly thyrotrophs, associated with hyperthyroidism.
  • To assess the reversibility of observed pituitary changes after treatment for thyrotoxicosis.

Main Methods:

  • Histologic and immunocytochemical examination of pituitary glands from 33 deceased thyrotoxic patients.

Related Experiment Videos

  • Avidin-biotin-peroxidase complex (ABC) immunostaining for pituitary hormones (GH, PRL, ACTH, TSH, FSH, LH, alpha-subunit).
  • Comparison of pituitary findings in thyrotoxic patients with treated patients and assessment of incidental pituitary adenomas.

    • Main Results:

    • A significant decrease or loss of thyrotropin (TSH) immunoreactivity was observed in all thyrotoxic pituitary glands.
    • Thyrotrophs were sparse, small, and showed faint TSH reactivity in thyrotoxicosis.
    • Loss of TSH immunoreactivity was reversible in treated patients, with normal or hyperplastic thyrotrophs observed.
    • No abnormalities were found in other adenohypophysial cells; incidental pituitary adenomas were found in 18% of cases.

    Conclusions:

    • Loss of pituitary thyrotropin (TSH) immunoreactivity is a consistent and distinguishing feature of thyrotoxicosis.
    • This TSH change is reversible upon treatment and normalization of thyroid function.
    • The pituitary gland adapts to thyrotoxicosis primarily through changes in thyrotrophs, while other cell types and structures remain unaffected.