In a short girl with celiac disease and Hashimoto's thyroiditis (HT), the suspect of an associated pituitary lesion was suggested by the finding of a thyroid function pattern that was not compatible with HTrelated hypothyroidism (low FT4 with normal TSH). This case report reinforces the view that the finding of a normal TSH in presence of a low FT4 should always alert pediatricians and raise the suspect of central hypothyroidism, even when a primary thyroid disease has been already identified. In this case TSH deficiency played a critical role in disclosing diagnosis of craniopharyngioma (CP). Therefore, the subsequent workup was directed towards investigating pituitary function and morphology. Endocrinological investigations evidenced a picture of TSH and other pituitary hormone deficiency, whereas magnetic resonance imaging revealed an intrasellar CP. Therefore, in this case TSH deficiency played a key-role in disclosing CP diagnosis. Conclusions: the finding of a normal TSH in presence of a low FT4 should always alert pediatricians and raise the suspect of CH, even when a primary thyroid disease has been already identified.

Key-role of thyrotropin deficiency in disclosing craniopharyngioma diagnosis in a short girl with Hashimoto's thyroiditis.

AVERSA, TOMMASO
Primo
;
VALENZISE, Mariella;LOMBARDO, Fortunato;DE LUCA, Filippo
;
WASNIEWSKA, Malgorzata Gabriela
Ultimo
2016

Abstract

In a short girl with celiac disease and Hashimoto's thyroiditis (HT), the suspect of an associated pituitary lesion was suggested by the finding of a thyroid function pattern that was not compatible with HTrelated hypothyroidism (low FT4 with normal TSH). This case report reinforces the view that the finding of a normal TSH in presence of a low FT4 should always alert pediatricians and raise the suspect of central hypothyroidism, even when a primary thyroid disease has been already identified. In this case TSH deficiency played a critical role in disclosing diagnosis of craniopharyngioma (CP). Therefore, the subsequent workup was directed towards investigating pituitary function and morphology. Endocrinological investigations evidenced a picture of TSH and other pituitary hormone deficiency, whereas magnetic resonance imaging revealed an intrasellar CP. Therefore, in this case TSH deficiency played a key-role in disclosing CP diagnosis. Conclusions: the finding of a normal TSH in presence of a low FT4 should always alert pediatricians and raise the suspect of CH, even when a primary thyroid disease has been already identified.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11570/2745570
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