Reversible Hypothyroidism in Empty Sella Syndrome: A Case Report

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

Research output: Contribution to journalArticlepeer-review

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
DOIs
Publication statusPublished - 1998

Keywords

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

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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