Usefulness of thyrotropin (TSH)-releasing hormone test and nocturnal surgeof TSH for diagnosis of isolated deficit of TSH secretion

Citation
N. Yamakita et al., Usefulness of thyrotropin (TSH)-releasing hormone test and nocturnal surgeof TSH for diagnosis of isolated deficit of TSH secretion, J CLIN END, 86(3), 2001, pp. 1054-1060
Citations number
50
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Endocrynology, Metabolism & Nutrition","Endocrinology, Nutrition & Metabolism
Journal title
JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM
ISSN journal
0021-972X → ACNP
Volume
86
Issue
3
Year of publication
2001
Pages
1054 - 1060
Database
ISI
SICI code
0021-972X(200103)86:3<1054:UOT(HT>2.0.ZU;2-X
Abstract
Six patients with idiopathic isolated deficit of TSH secretion were examine d and reported on. Their clinical symptoms and routine biochemical data wer e unclear and were not specific for hypothyroidism. Serum triiodothyronine, free thyroxine and TSH levels were slightly low or low-normal. Basal metab olic rate and thyroidal I-123-uptake were also slightly low or low-normal. The response of serum TSH to TRH stimulation was blunted in all patients. N o nocturnal surge of serum TSH level could be seen in any of the patients. Empty sella was revealed in three patients, and pituitary microadenoma in o ne patient via magnetic resolution imaging. Antihuman pituitary cytosol ant ibody was seen in five patients. Autoimmunity may have played a role in the pathogenesis of idiopathic isolated TSH deficiency. Routine examination of thyroid function cannot easily detect this disease. TSH response to TRH stimulation and nocturnal surge of TSH should be examin ed when this disease is suspected.