title: Growth hormone-, alpha-subunit and thyrotrophin-cosecreting pituitary adenoma in familial setting of pituitary tumour.
abstract: A patient with acromegaly and hyperthyroidism due to a growth hormone-, thyrotrophin- and alpha-subunit-secreting pituitary adenoma is described. His decreased father had suffered from a pituitary tumour, and was likely to have had acromegaly as well. Plasma growth hormone and insulin-like growth factor I concentrations were elevated, with levels between 10 and 20 micrograms/l and 4.4 and 7.3 kU/l, respectively. In spite of hyperthyroidism (free thyroxine, 45 pmol/l; free triiodothyronine, 24 pmol/l), plasma thyrotrophin remained at 2.8 mU/l without any response to thyrotrophin-releasing hormone and could not be suppressed with exogenous administration of triiodothyronine. Plasma alpha-subunits were raised to 3.3-3.7 U/l (normal 0.4-1.1 U/l). Pathological examination of the surgically removed tumour showed a pituitary adenoma with the immunohistochemical presence of growth hormone, thyrotrophin, prolactin and alpha-subunit. This is the first report of a growth hormone-, thyrotrophin- and alpha-subunit-producing pituitary adenoma, which occurred in a familial setting.
authors.affiliation: Department of Endocrinology, University of Hospital Groingen, The Netherlands.
authors.forename: T P
authors.initials: TP
authors.lastname: Links
authors.forename: J F
authors.initials: JF
authors.lastname: Monkelbaan
authors.forename: R P
authors.initials: RP
authors.lastname: Dullaart
authors.forename: T W
authors.initials: TW
authors.lastname: van Haeften
mesh_terms: D000236:Adenoma / Q000235:genetics* / Q000378:metabolism* / Q000601:surgery; D000328:Adult; D013006:Growth Hormone / Q000378:metabolism*; D006801:Humans; D008297:Male; D008499:Medical Records; D010911:Pituitary Neoplasms / Q000235:genetics* / Q000378:metabolism* / Q000601:surgery; D011388:Prolactin / Q000378:metabolism; D013963:Thyroid Hormones / Q000097:blood; D013972:Thyrotropin / Q000378:metabolism*
chemical_list: D013963:Thyroid Hormones; D011388:Prolactin; D013972:Thyrotropin; D013006:Growth Hormone