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Elevated plasma TSH and hypothyroidism in children with hypothalamic hypopituitarism
The Journal of Clinical Endocrinology and Metabolism
|October 1, 1975
Summary
Elevated thyroid-stimulating hormone (TSH) in growth hormone deficiency patients suggests inadequate TSH biological activity. This indicates potential hypothalamic disorders affecting TSH secretion and thyroid function.
Area of Science:
- Endocrinology
- Pediatric Endocrinology
- Hormone Research
Background:
- Growth hormone deficiency (GHD) can coexist with hypothyroidism.
- Thyroid-stimulating hormone (TSH) regulation is complex and can be affected by hypothalamic and pituitary disorders.
Purpose of the Study:
- To investigate TSH levels and response to thyrotropin-releasing hormone (TRH) in children with GHD and hypothyroidism.
- To differentiate causes of hypothyroidism in GHD patients based on TSH response patterns.
Main Methods:
- Assessed basal TSH levels in patients with GHD and hypothyroidism.
- Administered intravenous TRH (200 mug/m2) and measured TSH response.
- Compared findings with GHD patients exhibiting hypothalamic hypothyroidism, pituitary hypothyroidism, or isolated GHD.
Main Results:
- Six patients with GHD and hypothyroidism showed elevated basal TSH with an exaggerated TSH response to TRH.
- This contrasts with other GHD subgroups: delayed TSH rise (hypothalamic), absent TSH (pituitary), or normal TSH increase (isolated GHD).
- Elevated TSH in hypothyroid GHD patients suggests intact pituitary-thyroid feedback but inadequate TSH function.
Conclusions:
- Elevated TSH in hypothyroid GHD patients indicates a pituitary-thyroid feedback loop is present.
- TSH may be secreted in a biologically less active form in some patients with hypothalamic disorders.
- This finding suggests a potential mechanism for hypothyroidism in certain GHD cases.