Reversible Hypothyroidism in Empty Sella Syndrome: A Case Report

Fumio Otsuka, Toshio Ogura, Nobuhiko Hayakawa, Seishi Harada, Jingo Kageyama, Hirofumi Makino

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

A 33 year-old Japanese woman complained of generalized fatigue, recurrent infections and gradual weight loss 1 year after her first delivery. During delivery, no excessive bleeding or change in blood pressure was noted. On endocrinologic examination 2 years after delivery, she was found to have severe adrenal insufficiency and hypothyroidism. Pituitary function tests revealed impaired responses of ACTH, PRL and gonadotropins, and normal response of GH. TSH response to TRH was delayed but not exaggerated. Cranial magnetic resonance imaging showed an empty sella. The adrenal glands were responsive to extrinsic ACTH, and adequately accumulated 123I-adosterol. Antipituitary and antithyroid autoantibodies were detected in her serum. She was diagnosed with partial hypopituitarism associated with empty sella syndrome. Approximately 2 months after administration of cortisone acetate 25 mg/ day her general condition was noticeably improved, with normalization of thyroid function and improvement of gonadotropin responses to GnRH. This case suggests that a physiologic dose of glucocorticoid is necessary to maintain not only thyroid function but also some of the remaining pituitary functions in patients with empty sella syndrome manifesting hypopituitarism.

Original languageEnglish
Pages (from-to)385-391
Number of pages7
JournalEndocrine Journal
Volume45
Issue number3
Publication statusPublished - 1998

Fingerprint

Empty Sella Syndrome
Hypopituitarism
Hypothyroidism
Gonadotropins
Adrenocorticotropic Hormone
Adosterol
Pituitary Function Tests
Thyroid Gland
Adrenal Insufficiency
Adrenal Glands
Gonadotropin-Releasing Hormone
Autoantibodies
Glucocorticoids
Fatigue
Weight Loss
Magnetic Resonance Imaging
Hemorrhage
Blood Pressure
Infection
Serum

Keywords

  • Antipituitary antibody
  • Empty sella syndrome
  • Glucocorticoid
  • Gonadotropin
  • Hypopituitarism
  • Reversible hypothyroidism

ASJC Scopus subject areas

  • Endocrinology

Cite this

Otsuka, F., Ogura, T., Hayakawa, N., Harada, S., Kageyama, J., & Makino, H. (1998). Reversible Hypothyroidism in Empty Sella Syndrome: A Case Report. Endocrine Journal, 45(3), 385-391.

Reversible Hypothyroidism in Empty Sella Syndrome : A Case Report. / Otsuka, Fumio; Ogura, Toshio; Hayakawa, Nobuhiko; Harada, Seishi; Kageyama, Jingo; Makino, Hirofumi.

In: Endocrine Journal, Vol. 45, No. 3, 1998, p. 385-391.

Research output: Contribution to journalArticle

Otsuka, F, Ogura, T, Hayakawa, N, Harada, S, Kageyama, J & Makino, H 1998, 'Reversible Hypothyroidism in Empty Sella Syndrome: A Case Report', Endocrine Journal, vol. 45, no. 3, pp. 385-391.
Otsuka F, Ogura T, Hayakawa N, Harada S, Kageyama J, Makino H. Reversible Hypothyroidism in Empty Sella Syndrome: A Case Report. Endocrine Journal. 1998;45(3):385-391.
Otsuka, Fumio ; Ogura, Toshio ; Hayakawa, Nobuhiko ; Harada, Seishi ; Kageyama, Jingo ; Makino, Hirofumi. / Reversible Hypothyroidism in Empty Sella Syndrome : A Case Report. In: Endocrine Journal. 1998 ; Vol. 45, No. 3. pp. 385-391.
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