The challenge of pituitary hyperplasia differential diagnosis in a young girl with growth arrest
Growth arrest is an alarming condition which requires precise and tempestive investigations in order to provide accurate diagnosis. Long-standing primary hypothyroidism (PHT) may rarely occur as a growth arrest as the only clinical sign at onset in children. The most common cause of PHT in children...
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Accademia Peloritana dei Pericolanti
2024-07-01
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| Series: | Atti della Accademia Peloritana dei Pericolanti - Classe di Scienze Medico-Biologiche |
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| Online Access: | https://cab.unime.it/journals/index.php/APMB/article/view/4273 |
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| author | Aurora Lanzafame Tiziana Abbate Giuseppina Zirilli Flavia Caime Domenico Corica Malgorzata Wasniewska |
| author_facet | Aurora Lanzafame Tiziana Abbate Giuseppina Zirilli Flavia Caime Domenico Corica Malgorzata Wasniewska |
| author_sort | Aurora Lanzafame |
| collection | DOAJ |
| description | Growth arrest is an alarming condition which requires precise and tempestive investigations in order to provide accurate diagnosis. Long-standing primary hypothyroidism (PHT) may rarely occur as a growth arrest as the only clinical sign at onset in children. The most common cause of PHT in children and adolescents is represented by Hashimoto’s thyroiditis (HT), an autoimmune disease which frequently presents clinically with goitre. Rarely, HT may present as an atrophic variant without goitre, which may delay the diagnosis of PHT. Long-standing PHT is an unusual cause of pituitary hyperplasia (PH) and it has to be differentiated from severe conditions, including neoplasms. Loss of thyroxine feedback determines overproduction of thyrotropin releasing hormone, thyrotropin (TSH)-releasing cells hyperplasia and a consequent pituitary enlargement. Levothyroxine replacement therapy usually determines regression of PH. This report describes a case of an 11-year-old girl suffering from PHT and secondary PH due to autoimmune atrophic thyroiditis whose only onset symptom was growth arrest.
Thyroid hormone evaluation should be included in the first step of evaluations in patients with growth arrest even in the absence of clear clinical signs suggestive of thyroid disfunction. In patients with pituitary enlargement, thyroid function tests are important to recognize PH secondary to PHT and to avoid unnecessary surgery. |
| format | Article |
| id | doaj-art-abe7baa45acb46be9fe85a30a5105251 |
| institution | Kabale University |
| issn | 1828-6550 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | Accademia Peloritana dei Pericolanti |
| record_format | Article |
| series | Atti della Accademia Peloritana dei Pericolanti - Classe di Scienze Medico-Biologiche |
| spelling | doaj-art-abe7baa45acb46be9fe85a30a51052512025-08-20T03:51:18ZengAccademia Peloritana dei PericolantiAtti della Accademia Peloritana dei Pericolanti - Classe di Scienze Medico-Biologiche1828-65502024-07-0111211510.13129/1828-6550/APMB.112.1.2024.CCS23386The challenge of pituitary hyperplasia differential diagnosis in a young girl with growth arrestAurora Lanzafame0Tiziana Abbate1Giuseppina Zirilli2Flavia Caime3Domenico Corica4Malgorzata Wasniewska5Department of Human Pathology of Adulthood and Childhood, University of MessinaDepartment of Human Pathology of Adulthood and Childhood, University of MessinaDepartment of Human Pathology of Adulthood and Childhood, University of MessinaDepartment of Human Pathology of Adulthood and Childhood, University of MessinaDepartment of Human Pathology of Adulthood and Childhood, University of MessinaDepartment of Human Pathology of Adulthood and Childhood, University of MessinaGrowth arrest is an alarming condition which requires precise and tempestive investigations in order to provide accurate diagnosis. Long-standing primary hypothyroidism (PHT) may rarely occur as a growth arrest as the only clinical sign at onset in children. The most common cause of PHT in children and adolescents is represented by Hashimoto’s thyroiditis (HT), an autoimmune disease which frequently presents clinically with goitre. Rarely, HT may present as an atrophic variant without goitre, which may delay the diagnosis of PHT. Long-standing PHT is an unusual cause of pituitary hyperplasia (PH) and it has to be differentiated from severe conditions, including neoplasms. Loss of thyroxine feedback determines overproduction of thyrotropin releasing hormone, thyrotropin (TSH)-releasing cells hyperplasia and a consequent pituitary enlargement. Levothyroxine replacement therapy usually determines regression of PH. This report describes a case of an 11-year-old girl suffering from PHT and secondary PH due to autoimmune atrophic thyroiditis whose only onset symptom was growth arrest. Thyroid hormone evaluation should be included in the first step of evaluations in patients with growth arrest even in the absence of clear clinical signs suggestive of thyroid disfunction. In patients with pituitary enlargement, thyroid function tests are important to recognize PH secondary to PHT and to avoid unnecessary surgery.https://cab.unime.it/journals/index.php/APMB/article/view/4273pituitary hyperplasia, primary hypothyroidism, growth arrest, autoimmune thyroiditis |
| spellingShingle | Aurora Lanzafame Tiziana Abbate Giuseppina Zirilli Flavia Caime Domenico Corica Malgorzata Wasniewska The challenge of pituitary hyperplasia differential diagnosis in a young girl with growth arrest Atti della Accademia Peloritana dei Pericolanti - Classe di Scienze Medico-Biologiche pituitary hyperplasia, primary hypothyroidism, growth arrest, autoimmune thyroiditis |
| title | The challenge of pituitary hyperplasia differential diagnosis in a young girl with growth arrest |
| title_full | The challenge of pituitary hyperplasia differential diagnosis in a young girl with growth arrest |
| title_fullStr | The challenge of pituitary hyperplasia differential diagnosis in a young girl with growth arrest |
| title_full_unstemmed | The challenge of pituitary hyperplasia differential diagnosis in a young girl with growth arrest |
| title_short | The challenge of pituitary hyperplasia differential diagnosis in a young girl with growth arrest |
| title_sort | challenge of pituitary hyperplasia differential diagnosis in a young girl with growth arrest |
| topic | pituitary hyperplasia, primary hypothyroidism, growth arrest, autoimmune thyroiditis |
| url | https://cab.unime.it/journals/index.php/APMB/article/view/4273 |
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