ACTH-secreting pituitary microadenomas are associated with a higher prevalence of central hypothyroidism compared to other microadenoma types.

Clinical Endocrinology
Nestoras MathioudakisRoberto Salvatori

Abstract

Unlike pituitary macroadenomas, microadenomas (micros) are not commonly associated with hypopituitarism. In clinical practice, we have observed that patients with ACTH-secreting micros have a higher than expected prevalence of central hypothyroidism (HT), and we speculated that this effect might be because of glucocorticoid-induced suppression of the hypothalamic-pituitary-thyroid axis. To determine whether there is a difference in the prevalence of central HT among ACTH micros compared to other types of microadenoma, and if so, to investigate whether this is directly related to the degree of hypercortisolism. Retrospective study of 149 newly diagnosed patients with pituitary micros: 34 ACTH-secreting, 72 prolactin-secreting (PRLomas) and 43 clinically nonfunctioning adenomas (NFAs). Prevalence of central HT, correlation between normalized free T4 or TSH vs normalized urinary free cortisol (UFC) or salivary cortisol. The prevalence of central HT was significantly higher in the ACTH compared to the non-ACTH adenomas: 18% (ACTH), 1% (PRL) and 0% (NFAs). The mean normalized free T4 was lower in the ACTH micros compared to the non-ACTH micros (1·29 ± 0·06 vs 1·50 ± 0·23, P = 0·0001). There was no correlation between the degree of h...Continue Reading

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Citations

Aug 30, 2013·European Journal of Endocrinology·Oskar Ragnarsson, Gudmundur Johannsson
Apr 5, 2016·Indian Journal of Endocrinology and Metabolism·Jaya Prakash SahooMuthupillai Vivekanandan
Nov 3, 2016·Internal Medicine·Nobumasa OharaHirohito Sone
Apr 12, 2018·Archives of Endocrinology and Metabolism·Sema Ciftci DogansenSema Yarman
Jul 28, 2020·Pituitary·Wael M AlmistehiSyed Ali Imran
Nov 5, 2016·The Journal of Clinical Endocrinology and Metabolism·Maria FleseriuMary H Samuels
Sep 8, 2020·Internal Medicine·Yuji HiromatsuKei Mukohara
Sep 8, 2018·Endocrine·Ulla Feldt-RasmussenSalvatore Benvenga
Nov 26, 2020·The Journal of Clinical Endocrinology and Metabolism·Skand ShekharLynnette K Nieman
Apr 4, 2021·International Journal of Molecular Sciences·Rosa Maria ParagliolaSalvatore Maria Corsello

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