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Hyperprolactinaemia and microadenomas in primary hypothyroidism.
D J Thomas1, R Touzel, M Charlesworth
1Department of Endocrinology, St Bartholomew's Hospital, London, UK.
Clinical Endocrinology
|September 1, 1987
Summary
Primary hypothyroidism can cause hyperprolactinemia and pituitary abnormalities. Thyroid hormone replacement therapy does not always normalize elevated prolactin levels in these patients.
Area of Science:
- Endocrinology
- Radiology
Background:
- Primary hypothyroidism is associated with pituitary gland dysfunction.
- Hyperprolactinemia and pituitary abnormalities can occur in patients with hypothyroidism.
Purpose of the Study:
- To investigate the persistence of hyperprolactinemia and pituitary abnormalities in primary hypothyroidism patients after thyroid hormone replacement.
Main Methods:
- Documented hyperprolactinemia and pituitary abnormalities using high-resolution computed tomographic (CT) scans in 19 primary hypothyroidism patients.
- Monitored changes during thyroid hormone replacement for up to 28 months.
Main Results:
- At presentation, 12 patients (45%) had elevated serum prolactin (PRL).
- After treatment, 9 patients (34%) still had elevated PRL despite 10-18 months of therapy.
- Pretreatment CT scans revealed enlarged pituitaries in 11 patients, with five showing suprasellar extension. Microadenoma-like low attenuation areas were noted in 11 patients, persisting in five.
Conclusions:
- Hyperprolactinemia in hypothyroid patients may not resolve with thyroid hormone replacement.
- Pituitary abnormalities, including enlarged glands and potential microadenomas, can be present and persistent.
- Continued monitoring is essential for managing these complex endocrine-uitary interactions.