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      Pituitary Hyperplasia in a Girl with Gonadal Dysgenesis and Primary Hypothyroidism

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          A 16-year-old Brazilian girl presented with severe growth retardation (-6.3 SDS), obesity, delayed pubertal development, facial dysmorphia, dry skin, and borderline low intelligence (IQ 89). Endocrinological evaluation showed primary hypothyroidism (no uptake of iodine-131 of the right thyroid lobe). Basal and stimulated gonadotropins were increased and ultrasonography revealed hypoplastic ovaries. The karyotype of peripheral lymphocytes was 46, X, i(Xq). The GH response in euthyroid condition after stimulation with GHRH and insulin was diminished. MRI of the pituitary region showed a suprasellar mass (12 × 15 mm) which was removed by transsphenoidal surgery because of extension to the optic chiasm. Histological examinations revealed regular pituitary tissue with hyperplasia of TSH- and FSH-producing cells. Thyroxine treatment was adjusted and GH was given. We conclude that the suprasellar mass was the consequence of long-lasting hypothalamic over-stimulation with TRH and LHRH, due to gonadal and thyroid insufficiency.

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          Author and article information

          Horm Res Paediatr
          Hormone Research in Paediatrics
          S. Karger AG
          09 December 2008
          : 47
          : 3
          : 126-130
          Department of Pediatrics, University of Vienna, Austria
          185447 Horm Res 1997;47:126–130
          © 1997 S. Karger AG, Basel

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          Pages: 5
          Case Report


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