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Related Experiment Videos

Myxoedema presenting with chiasmal compression: resolution after thyroxine replacement.

B R Lecky, T D Williams, S L Lightman

    Lancet (London, England)
    |June 13, 1987
    PubMed
    Summary

    Pituitary enlargement causing vision loss in a woman was resolved with thyroid hormone replacement therapy. This highlights the importance of measuring thyroid-stimulating hormone (TSH) in pituitary disorders.

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    Area of Science:

    • Endocrinology
    • Neuro-ophthalmology

    Background:

    • Pituitary enlargement can cause visual field defects due to compression of the optic chiasm.
    • Thyroid dysfunction can sometimes manifest with pituitary abnormalities.

    Observation:

    • A 60-year-old woman presented with deteriorating vision and a computed tomography (CT) scan revealed pituitary enlargement with chiasmal compression.
    • Thyroid function tests showed low thyroxine and markedly elevated thyroid-stimulating hormone (TSH) levels.

    Findings:

    • After 8 weeks of thyroxine replacement therapy, the patient's visual defects resolved.
    • The pituitary gland size significantly reduced on CT scan, and TSH levels normalized.
    • Serum prolactin levels were normal, indicating the pituitary enlargement was not solely due to a prolactinoma.

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    Implications:

    • Measurement of TSH is crucial in patients with pituitary enlargement, alongside prolactin levels.
    • Timely diagnosis and treatment of hypothyroidism can reverse pituitary enlargement and associated visual symptoms.
    • This case underscores the importance of a comprehensive endocrine workup to avoid unnecessary pituitary surgery.