Key-role of thyrotropin deficiency in disclosing craniopharyngioma diagnosis in a short girl with Hashimoto's thyroiditis.
In a short girl with celiac disease and Hashimoto's thyroiditis (HT), suspicion of an associated pituitary lesion was suggested by the finding of a thyroid function pattern that was not compatible with HT-related hypothyroidism (low FT4 with normal TSH). This case report reinforces the view that the finding of a normal TSH in presence of a low FT4 should always alert pediatricians and raise suspicion of central hypothyroidism, even when a primary thyroid disease has been already identified. In this case TSH deficiency played a critical role in disclosing diagnosis of craniopharyngioma (CP). Therefore, the subsequent work-up was directed towards investigating pituitary function and morphology. Endocrinological investigations evidenced a picture of TSH and other pituitary hormone deficiency, whereas magnetic resonance imaging revealed an intrasellar CP. Therefore, in this case TSH deficiency played a key-role in disclosing CP diagnosis.
Department of Pediatrics, University of Messina, Messina, Italy - filippo.deluca@unime.it.
Tommaso
T
Aversa
Mariella
M
Valenzise
Giuseppina
G
Zirilli
Fortunato
F
Lombardo
Filippo
F
De Luca
Malgorzata
M
Wasniewska
D001827:Body Height; D002446:Celiac Disease / Q000150:complications; D002648:Child; D003397:Craniopharyngioma / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D050031:Hashimoto Disease / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging; D010911:Pituitary Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D013972:Thyrotropin / Q000172:deficiency*
D013972:Thyrotropin