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严重的小发性甲状腺功能低下症在儿童呈现为下垂体瘤:一个病例报告
Victoria Leal1, Shokery Awadalla1
1Pediatric Endocrinology, Fundacion Universitaria de Ciencias de la Salud, Bogotá, COL.
Cureus
|November 19, 2025
概括
儿童的原发性甲状腺功能低下症可能导致垂体过度增生,模仿垂体质量. 及时进行甲状腺功能测试至关重要,以避免儿童患者的误诊和不必要的手术.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 神经内分泌学神经内分泌学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 儿童的原发性甲状腺功能低下症可能导致垂体过度增生.
- 这种增生是由于慢性发育激素释放激素 (TRH) 刺激造成的.
- 未经治疗的甲状腺功能低下症可能会导致垂体扩大,在成像上模仿垂体质量.
研究的目的:
- 报告一个被误诊为垂体腺瘤的垂体过度增生病例.
- 强调在怀疑患有脑下垂体质量的儿童中评估甲状腺功能的重要性.
- 为了突出甲状腺激素替代性脑下垂体激增的可逆性.
主要方法:
- 一个9岁的病人出现头痛的病例报告.
- 诊断评估包括甲状腺功能的血液检测 (TSH,自由T4).
- 脑下垂体的磁共振成像 (MRI).
- 用levothyroxine进行治疗和随访成像.
主要成果:
- 一位患者出现了暗示下垂体质量的症状.
- 血液测试证实了严重的原发性甲状腺功能低下症 (TSH升高,T4抑制).
- 最初的MRI被解释为垂体腺瘤.
- 下垂体过度增生在勒沃西治疗后完全消失.
结论:
- 在儿童下垂体质量差异诊断时,应考虑甲状腺功能低下症.
- 由于甲状腺功能低下症而导致的垂体过度增生是可逆的治疗.
- 甲状腺功能测试在儿科患者的脑垂体病变手术前是必不可少的.
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