Empty sella and primary autoimmune hypothyroidism

García-Centeno, Rogelio; Llanos, José Pablo Suárez; Fernández-Fernández, E.; Andía-Melero, Víctor M; Sánchez, Petra; Jara-Albarrán, A.

doi:10.1007/s10238-009-0071-z

Cited by 4 publications

(6 citation statements)

References 52 publications

(54 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Different etiologies may be present among patients diagnosed with primary ESS (5). García-Centeno et al (8) reported HT frequency as 26.7% among primary ESS patients (9). In the present study, the frequency of HT was 22.2% among primary ESS patients.…”

Section: Discussionsupporting

confidence: 56%

Relationship between Empty Sella Syndrome and Hashimoto’s Thyroiditis

Kuzu¹,

Zuhur²,

Özel³

et al. 2016

tjem

View full text Add to dashboard Cite

It is not clear if Hashimoto's thyroiditis leads to Empty sella syndrome. In the present study, we aimed to investigate if Hashimoto's thyroiditis was associated with Empty sella syndrome, and Hashimoto's thyroiditis was a secondary cause od some cases of primary Empty sella syndrome. Material and Method: Eighty-one patients who were diagnosed with primary Empty sella syndrome were included in the study. All patients underwent thyroid ultrasonography and biochemical tests for thyroid-stimulating hormone, free triiodothyronine, free thyroxine, anti thyroid peroxidase, anti thyroglobulin, follicle stimulating hormone, luteinizing hormone, 17 β estradiol, growth hormone, insulin-like growth factor 1, adrenocorticotropic hormone and total testosterone for Hashimoto's thyroiditis and pituitary hormone deficiency. Results: Out of 81 patients, thyroid disease was diagnosed in 34 (42%) patients; 18 of them had Hashimoto's thyroiditis (22.2%) and 16 (19.8%) had central hypothyroidism. Among Hashimoto's thyroiditis patients, 11 (13.6%) had hypothyroidism and 7 (8.6%) were euthyroid. Discussion: In conclusion, it is possible that some cases of primary Empty sella syndrome are caused by Hashimoto's thyroiditis. It is recommended that the presence of Hashimoto's thyroiditis should be investigated in patients with primary Empty sella syndrome. Further studies investigating anti-pituitary antibody in patients with primary Empty sella syndrome, are needed to further declare this relationship.

show abstract

Section: Discussionsupporting

confidence: 56%

Relationship between Empty Sella Syndrome and Hashimoto’s Thyroiditis

Kuzu¹,

Zuhur²,

Özel³

et al. 2016

tjem

View full text Add to dashboard Cite

show abstract

“…2 In a recent series of 56 patients with empty sella syndrome, a possible outcome of lymphocytic hypophysitis, AITD was found in 27%, but local controls were not included. 8 An association has also been reported between AITD and isolated growth hormone deficiency, which occurred in 5% of patients and could reflect an autoimmune hypophysitis, 9 but a recent study has been unable to confirm such a high prevalence of growth hormone deficiency in AITD. 10 In idiopathic hypoparathyroidism, there is no clear increase in AITD, despite growing evidence that the calcium-sensing receptor is the target of autoimmunity in at least a subset of patients.…”

Section: Autoimmune Endocrinopathiesmentioning

confidence: 99%

“…AITD appears to be increased in patients with lymphocytic hypophysitis but exact data are not available given the rarity of this condition 2 . In a recent series of 56 patients with empty sella syndrome, a possible outcome of lymphocytic hypophysitis, AITD was found in 27%, but local controls were not included 8 . An association has also been reported between AITD and isolated growth hormone deficiency, which occurred in 5% of patients and could reflect an autoimmune hypophysitis, 9 but a recent study has been unable to confirm such a high prevalence of growth hormone deficiency in AITD 10 …”

Section: Autoimmune Disease Associations With Aitdmentioning

confidence: 99%

Diseases associated with thyroid autoimmunity: explanations for the expanding spectrum

Weetman

2011

Clinical Endocrinology

View full text Add to dashboard Cite

SummaryAnyone who has been in an endocrine clinic will appreciate that associations exist between autoimmune thyroid disease (AITD) and other autoimmune disorders. However, the full extent of these associations is still not fully appreciated, and new associations are being uncovered which may shed new light on the pathogenic basis for these connections, and the underlying reasons for them are only now becoming understood. This review is based on the British Thyroid Association Pitt-Rivers Lecture 2010. The first section provides an update on studies which have detailed the strength of various autoimmune disease associations, the second section discusses the environmental and genetic factors which underlie these associations and the final section describes some recently identified, unexpected AITD associations. Unravelling these associations further will illuminate the pathogenesis of autoimmune diseases and offers the prospect of new therapeutic approaches. Autoimmune disease associations with AITDOnce the autoimmune basis for autoimmune hypothyroidism and Graves' disease was established, it also became obvious that these two disorders were associated in families and that asymptomatic relatives of affected probands had a higher frequency of thyroid autoantibodies. Moreover, other autoimmune diseases were observed to cluster in the same individuals and their families. Indeed, for some disorders, such associations constituted important evidence for a likely autoimmune aetiology. Identifying the basis for this shared pathogenesis is important to our fundamental understanding of disease mechanisms and also has clinical ramifications in terms of when we might best screen for associated diseases.Identifying whether disease associations exist is not as straightforward as it appears at first sight. Because the prevalence of AITD multiplied by the proportion of AITD patients with a second autoimmune disease must equal the prevalence of the second autoimmune disease multiplied by the proportion of patients with AITD, it is usually more revealing to examine the prevalence of AITD in more uncommon autoimmune diseases when studying associations than the reverse. Other problems encountered with apparently easy to perform association studies are detailed in Table 1. This first section describes studies on the strength of various autoimmune disease associations with AITD since I last reviewed this topic. 1,2 Autoimmune polyglandular syndromes (APS)AITD is a feature of both APS type 1 and 2, but is far commoner in the latter (Table 2). Type 1 APS is caused by mutations in the AIRE (autoimmune regulator) gene which controls the transcription of organ-specific autoantigens in the thymus during ontogeny; such mutations result in a failure to inactivate autoreactive T cells. The relatively low prevalence of AITD in APS type 1 may indicate that other pathways (either thymic or peripheral) besides that involving AIRE are more important for tolerance to thyroid autoantigens, although a novel mutation in AIRE (G228W in exon 6) has been...

show abstract

“…In total, 165 subjects were included from the 29 studies. Of these, 46 subjects were in studies on primary hypothyroidism [52][53][54][55][56][57][58][59][60][61][62][63][64][65][66] (i.e. in which hypothyroidism was related to ID), 97 subjects in studies on congenital hypothyroidism [67][68][69][70][71][72][73][74][75][76][77], 3 subjects in a study of endemic cretinism [78], 11 subjects in a study of subclinical hypothyroidism [79,80] and 8 subjects in a study of perinatal hypothyroidism [80] (Figure 2).…”

Section: Sample Sizementioning

confidence: 99%

“…Ten studies gave implicit inclusion/exclusion criteria through the description of the characteristics of the sample and five gave them explicitly [67,69,74,76,77]. Reasons for rejection were patients with unrelated disorders which may affect cerebral function or development such as chromosomal or metabolic Only 7 MRI studies utilised contrast enhancement; Gadolinium was used in each of these [55][56][57][60][61][62]65]. Both MRS studies [67,72] used shimming techniques and water suppression chemical shift selection pulses but only one study discussed the additional use of Stimulated Echo Acquisition Mode (STEAM) [72].…”

Section: Blinding Randomisation and Inclusion/exclusion Criteriamentioning

confidence: 99%

Brain Findings Associated with Iodine Deficiency Identified by Magnetic Resonance Methods: A Systematic Review

Hernández¹,

Wilson²,

Combet³

et al. 2013

OJRad

View full text Add to dashboard Cite

Objectives: Iodine deficiency (ID) is a common cause of preventable brain damage and mental retardation worldwide, according to the World Health Organisation. It may adversely affect brain maturation processes that potentially result in structural and metabolic brain abnormalities, visible on Magnetic Resonance (MR) techniques. Currently, however, there has been no review of the appearance of these brain changes on MR methods. Methods: A systematic review was conducted using 3 online search databases (Medline, Embase and Web of Knowledge) using multiple combinations of the following search terms: iodine, iodine deficiency, magnetic resonance, MRI, MRS, brain, imaging and iodine deficiency disorders (i.e. hypothyroxinaemia, congenital hypothyroidism, hypothyroidism and cretinism). Results: Up to May 2013, 1673 related papers were found. Of these, 29 studies confirmed their findings directly using MR Imaging and/or MR Spectroscopy. Of them, 28 were in humans and involved 157 subjects, 46 of whom had primary hypothyroidism, 97 had congenital hypothyroidism, 3 had endemic cretinism and 11 had subclinical hypothyroidism. The studies were small, with a mean relevant sample size of 6, median 2, range 1 -35, while 14 studies were individual case reports. T1-weighted was the most commonly used MRI sequence (20/29 studies) and 1.5 Tesla was the most commonly used magnet strength (6/10 studies that provided this information). Pituitary abnormalities (18/29 studies) and cerebellar atrophy (3/29 studies) were the most prevalent brain abnormalities found. Only fMRI studies (3/29) reported cognition-related abnormalities but the brain changes found were limited to a visual description in all studies. Conclusions: More studies that use MR methods to identify changes on brain volume or other global structural abnormalities and explain the mechanism of ID causing thyroid dysfunction and hence cognitive damage are required. Given the role of MR techniques in cognitive studies, this review provides a starting point for researching the macroscopic structural brain changes caused by ID.

show abstract

Empty sella and primary autoimmune hypothyroidism

Cited by 4 publications

References 52 publications

Relationship between Empty Sella Syndrome and Hashimoto’s Thyroiditis

Relationship between Empty Sella Syndrome and Hashimoto’s Thyroiditis

Diseases associated with thyroid autoimmunity: explanations for the expanding spectrum

Brain Findings Associated with Iodine Deficiency Identified by Magnetic Resonance Methods: A Systematic Review

Contact Info

Product

Resources

About