Primary idiopathic hypothalamic hypothyroidism. Report of four cases.
One man and three women with hypothalamic hypothyroidism are described; they had isolated thyrotropin-releasing hormone deficiency, otherwise normal pituitary function, and no identifiable central nervous system anatomic abnormality. Serum thyrotropin levels were low and thyrotropic response to thyrotropin-releasing hormone was uniformly present, consistent with a hypothalamic cause of hypothyroidism. In two patients, hypothyroidism was transient and spontaneously resolved; in one of them, it was recurrent. Because hypothalamic hypothyroidism is mild and potentially reversible, it is suggested that such patients have follow-up evaluation before therapy is initiated in order to avoid unnecessary treatment.
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007027:Hypothalamic Diseases / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D007037:Hypothyroidism / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D012008:Recurrence; D012075:Remission, Spontaneous; D013960:Thyroid Function Tests; D013973:Thyrotropin-Releasing Hormone / Q000172:deficiency; D013974:Thyroxine / Q000627:therapeutic use
D013973:Thyrotropin-Releasing Hormone; D013974:Thyroxine