原发性甲状腺功能减退症合并垂体增生32例临床分析

Clinical analysis of 32 cases of pituitary hyperplasia secondary to primary hypothyroidism

目的通过对原发性甲状腺功能减退症（甲减）合并垂体增生的临床和影像学资料的分析，了解其临床特点及甲状腺激素替代治疗后的影像学变化。方法分析华山医院1999至2008年门诊和住院的32例甲减合并垂体增生的患者的临床表现、激素水平、影像学检查以及治疗后随访结果。结果32例患者多为青少年，病程在半年～8年之间，除甲减的表现外，影像学上可见垂体饱满或弥漫性增大。甲状腺素替代治疗后，1～6个月后垂体可缩小至正常。结论青少年的原发性甲减易伴垂体增生，原发性甲减所致的垂体增生在充分的甲状腺素替代治疗后可完全逆转。

Objective To improve the recognition of pituitary hyperplasia secondary to primary hypothyroidism by analyzing clinical and imaging data. Methods The clinical features, hormone data, imaging findings, and treatment were reviewed in 32 patients with pituitary hyperplasia secondary to primary hypothyroidism in Huashan Hospital from 1999 to 2008. Results Thirty-two patients, most juvenile, presented clinical and imaging features suggestive of functional primary pituitary adenoma. The dose of levothyroxine was increased to maintain the thyrotropin concentration at normal values. Following adequate thyroxine replacement, pituitary hyperplasia regressed on average within 6 months. Conclusions Pituitary hyperplasia secondary to primary hypothyroidism seems to be quite prevalent in children and adolescents. Complete regression will be achieved with thyroxine replacement therapy.