Primary hypothyroidism in a child leads to pituitary hyperplasia: A case report and literature review

Rationale:
A sellar mass in children is most often seen in craniopharyngeal tumors, intracranial germ cell tumors, or pituitary adenomas. However, pituitary hyperplasia secondary to primary hypothyroidism (PHPH) is not commonly seen in children.
Patient concerns:
A 10-year-old girl was admitted due to growth retardation and obesity for 4 years. On physical examination, the patient had a height of 118 cm, body weight of 46 kg, body mass index (BMI) of 33.0 kg/m2.
Diagnoses:
After magnetic resonance imaging (MRI) and laboratory tests, her initial diagnosis was Hashimoto's thyroiditis, primary hypothyroidism, and reactive pituitary hyperplasia.
Interventions:
She was treated with oral L-thyroxine tablets.
Outcomes:
After 6 months, physical examination showed a height of 125 cm, weight of 36 kg, BMI of 23.0 kg/m2. She developed well, with 12 cm of yearly growth thereafter.
Lessons:
The diagnosis of PHPH in a child is very important and sometimes difficult. Based on the summary and analysis of previous cases, we can learn that the main manifestations of PHPH include growth arrest and obesity, perhaps accompanied by symptoms caused by a decreased thyroid hormone concentration and elevated prolactin (PRL) concentration. Intracranial MRI shows diffuse enlargement of the anterior lobe of the pituitary gland, with a dome-shaped blunt edge change. Thyroid hormone levels may decrease, whereas the thyroid stimulating hormone (TSH) level increases, commonly a...

Source: Medicine - October 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research