A thyrotropin-secreting pituitary adenoma as a cause of thyrotoxic periodic paralysis.
We describe a patient with thyrotoxic periodic paralysis (TPP) caused by a thyrotropin-secreting pituitary adenoma. The diagnosis TPP was based on the combination of episodes of reversible hypokalaemic paralysis, hyperthyroidism and electrophysiological findings. A thyrotropin-secreting pituitary adenoma was diagnosed on the basis of endocrinological function tests and MRI of the pituitary gland. Before transsphenoidal resection of the adenoma, treatment with octreotide restored euthyroidism both clinically and biochemically. Immunocytochemistry of the pituitary adenoma was positive for TSH exclusively. Incubation with octreotide or quinagolide induced decreased TSH and alpha-subunit production by the cultured adenoma cells, in agreement with the pre-operative in vivo data. This paper is the first to describe in vivo and in vitro characteristics of a thyrotropin-secreting pituitary adenoma in a patient presenting with periodic paralysis.
Alings
A M
AM
Department of Endocrinology and Metabolism, Academical Medical Center of the University of Amsterdam, The Netherlands.
Fliers
E
E
de Herder
W W
WW
Hofland
L J
LJ
Sluiter
H E
HE
Links
T P
TP
van der Hoeven
J H
JH
Wiersinga
W M
WM
D000236:Adenoma / Q000150:complications / Q000378:metabolism* / Q000628:therapy; D000328:Adult; D006801:Humans; D006980:Hyperthyroidism / Q000209:etiology*; D007008:Hypokalemia / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D015282:Octreotide / Q000627:therapeutic use; D010243:Paralysis / Q000209:etiology*; D010911:Pituitary Neoplasms / Q000150:complications / Q000378:metabolism* / Q000628:therapy; D013972:Thyrotropin / Q000378:metabolism*; D013973:Thyrotropin-Releasing Hormone
D013973:Thyrotropin-Releasing Hormone; D013972:Thyrotropin; D015282:Octreotide