Central hypothyroidism

Gupta, Vishal; Lee, Marilyn

doi:10.4103/2230-8210.83337

Cited by 41 publications

(33 citation statements)

References 56 publications

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“…In primary HT, normal stimulation of the thyroid by TSH occurs, but the thyroid is unable to produce sufficient thyroid hormones in response. Secondary HT is characterized by a lesion in the pituitary gland, and tertiary HT is due to insufficient stimulation from the hypothalamus [Gupta and Lee, 2011]. Although the hypometabolic state associated with HT reduces the oxidative damage caused by toxins, many studies have demonstrated that it can lead to other cellular and organ injuries.…”

Section: Introductionmentioning

confidence: 99%

Bone Marrow-Derived Mesenchymal Stem Cells Ameliorate the Pancreatic Changes of Chemically Induced Hypothyroidism by Carbimazole in Male Rats

Arafa

Gouda

El-naseery

et al. 2018

Cells Tissues Organs

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We induced hypothyroidism (HT) in male rats through chronic oral administration of carbimazole and then tested whether an i.v. injection of rat bone marrow-derived mesenchymal stem cells (BM-MSCs) could ameliorate the HT-induced changes in pancreatic structure and function. The thyroid and pancreatic function tests, as well as total antioxidant capacity (TAC) and malondialdehyde (MDA) were estimated. The pancreatic structure was evaluated by hematoxylin and eosin (H&E) stain. Insulin protein and cleaved caspase-3 were detected immunohistochemically. The degree of apoptosis was assessed by TUNEL assay. The morphometric measurements were done by an image analyzer system and the obtained data were statistically analyzed. HT rats showed hyperglycemia associated with insulin deficiency, decreased TAC and increased MDA levels. H&E-stained sections showed that the pancreatic septa were infiltrated with acidophilic material. Some acini were vacuolated while others showed depleted acidophilia and dilated lumina. Spindle-shaped cells were accumulated within deformed islets in HT rats. The positive reaction with anti-cleaved caspase-3 was exclusively noted in the cytoplasm of islet cells with no immunostaining reaction in the acinar and ductal cells, whereas the positively stained nuclei with TUNEL were demonstrated in the islet and acinar cells. A significant increase in the apoptotic index % of both markers was detected. Injection of BM-MSCs in HT rats restored all biochemical indicators of disturbed pancreatic function to normal level and improved pancreatic structure, resulting in a clear septa and normal appearance of acini and islets. In conclusion, many of the significant structural and func tional pancreatic alterations detected in HT rats were ameliorated after the injection of BM-MSCs. These data demonstrate the ability of BM-MSCs to repair pancreatic disturbances. Further studies on humans are necessary to determine the potential clinical applications of BM-MSCs.

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Section: Introductionmentioning

confidence: 99%

Bone Marrow-Derived Mesenchymal Stem Cells Ameliorate the Pancreatic Changes of Chemically Induced Hypothyroidism by Carbimazole in Male Rats

Arafa

Gouda

El-naseery

et al. 2018

Cells Tissues Organs

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“…In cases of ACTH-secreting pituitary adenomas, excess glucocorticoid levels could have caused the blunted response of TSH [23]. Central hypothyroidism accompanied by Rathke’s cleft cysts [24] or craniopharyngiomas [25] has often been reported. These lesions were thought to be larger than those of other pituitary diseases at the time of surgery because of late detection; however, our obtained data (without data on the size or extent of pituitary disease) were not relevant for pertinent analysis.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Thyroid Disease in Patients Surgically Treated for Pituitary Disease

Kim

Cho

et al. 2019

JCM

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Thyroid disease mainly has a thyroid origin but can occasionally have a pituitary origin. Clinicians face several challenges when these conditions occur together. We aimed to determine the prevalence of thyroid disorders in patients undergoing trans-sphenoidal adenomectomy (TSA) for pituitary disease. We reviewed the medical records of patients undergoing TSA for pituitary disease between 2008 and 2017 at Severance Hospital. Thyroid disorders were categorized using blood test results and medical histories at the time of preoperative evaluation. Among 2202 patients, 44 (2%), 218 (9.9%), and 74 (3.4%) had hyperthyroidism, hypothyroidism, and post-thyroidectomy status before TSA, respectively. Among the 44 patients with hyperthyroidism, 30 (68.2%) had central hyperthyroidism. Among the 218 patients with hypothyroidism, 165 (75.7%) had central hypothyroidism. Central hypothyroidism was more common in patients with adrenocorticotropic hormone-secreting pituitary adenomas (aOR (adjusted odds ratio) 1.85), Rathke’s cleft cysts (aOR 2.34), and craniopharyngiomas (aOR 2.58) (all p < 0.05) than in those with nonfunctioning pituitary adenomas. Contrastingly, thyroid cancer had an increased prevalence in patients with growth hormone- (aOR 3.17), prolactin- (aOR 3.66), and thyroid-stimulating hormone-secreting (aOR 6.28) pituitary adenomas (all p < 0.05). Pituitary disease sometimes accompanies thyroid disorders; their characteristics vary according to the type of pituitary disease.

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“…TSH was normal in our case in the presence of low T3 and T4 hormone level which can be seen in secondary hypothyroidism. [ 10 ] The importance of a good liaison between the clinical departments cannot be stressed enough in the management of this patient.…”

Section: Discussionmentioning

confidence: 99%

Psychosis in Secondary Empty Sella Syndrome following a Russell's Viper Bite

Ratnakaran¹,

Punnoose

Das

et al. 2016

Indian Journal of Psychological Medicine

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Hypopituitarism can present with psychiatric symptoms. We report a unique case of psychosis in clear consciousness in a case of hypopituitarism due to the secondary empty sella syndrome following a Russell's viper bite which was untreated and presented with psychotic symptoms for past 13 years following the snake bite. After the diagnosis of psychosis due to hypopituitarism was made, the patient was treated with levothyroxine and prednisolone supplements and his psychotic symptoms subsided without any psychotropic drugs. Vasculotoxic snake bites can cause hypopituitarism and can present with psychosis. Further research will be needed into the prevalence of this phenomenon.

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Central hypothyroidism

Cited by 41 publications

References 56 publications

Bone Marrow-Derived Mesenchymal Stem Cells Ameliorate the Pancreatic Changes of Chemically Induced Hypothyroidism by Carbimazole in Male Rats

Bone Marrow-Derived Mesenchymal Stem Cells Ameliorate the Pancreatic Changes of Chemically Induced Hypothyroidism by Carbimazole in Male Rats

Prevalence of Thyroid Disease in Patients Surgically Treated for Pituitary Disease

Psychosis in Secondary Empty Sella Syndrome following a Russell's Viper Bite

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