Less known aspects of central hypothyroidism: Part 2 – Congenital etiologies

Benvenga, Salvatore; Klose, Marianne; Vita, Roberto; Feldt‐Rasmussen, Ulla

doi:10.1016/j.jcte.2018.09.004

Cited by 5 publications

(5 citation statements)

References 49 publications

(81 reference statements)

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“…Thyrotrophs are localised in the antero-medial region of the anterior pituitary gland and make up the least (<5%) of the total anterior pituitary cell population ( 5 ). Growth hormone (somatotrophs) and sex steroids (gonadotrophs) are typically the first hormones affected in cases of hypopituitarism caused by pituitary adenomas, with thyrotrophic and corticotrophic involvement manifesting at a later stage of the disease.…”

Section: Discussionmentioning

confidence: 99%

Central hypothyroidism related to antipsychotic and antidepressant medications: an observational study and literature review

Keen

Chalishazar

Mitchem

et al. 2022

European Thyroid Journal

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Objective: To investigate the final diagnosis and clinical outcome of patients referred to endocrinology in our district general hospital with biochemical isolated central hypothyroidism, and whether there is an association between this biochemical picture and treatment with antidepressant and antipsychotic medications. Methods: We performed a retrospective observational study of patients referred to endocrinology with unexplained biochemical isolated central hypothyroidism over a 5 year period. Results: Of the 29 patients included in the study, 4 were found to have a partially empty or empty sella, and 1 to have a bulky pituitary gland which was deemed to be an incidental radiological finding. No patients had any clinically significant pathology. On reviewing their medications, 18/29 (62%) were found to be on psychotropic medications. Conclusions: Our study suggests a relationship between patients on psychotropic medications and biochemical isolated central hypothyroidism, an association only described in a very limited amount of literature prior to this. The mechanism behind this may be suppression of TSH secretion via antagonism of the dopamine-serotoninergic pathway. Determining a correlation between psychotropic medications and isolated central hypothyroidism could lead to the avoidance of further radiological investigations and unnecessary anxiety for patients. However, a larger observational study is needed to provide further evidence to support/refute our finding.

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Section: Discussionmentioning

confidence: 99%

Central hypothyroidism related to antipsychotic and antidepressant medications: an observational study and literature review

Keen

Chalishazar

Mitchem

et al. 2022

European Thyroid Journal

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“…Hypernatremia and diabetes insipidus were significantly more frequent in our cohort compared to Harvengt series. Central hypothyroidism is present in 30% of ROHHAD patients and growth hormone deficiency in approximately half of patients ( 21 , 22 ). In a study published by Bougnères et al ( 17 ) in 2008, describing endocrine abnormalities in patients diagnosed with ROHHAD, all of the patients presented blood serum abnormalities, hyperprolactinemia and dysthyroidism.…”

Section: Discussionmentioning

confidence: 99%

ROHHAD syndrome without rapid-onset obesity: A diagnosis challenge

Desse¹,

Tran

Butori

et al. 2022

Front. Pediatr.

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BackgroundROHHAD syndrome (Rapid-onset Obesity with Hypothalamic dysfunction, Hypoventilation and Autonomic Dysregulation) is rare. Rapid-onset morbid obesity is usually the first recognizable sign of this syndrome, however a subset of patients develop ROHHAD syndrome without obesity. The prevalence of this entity is currently unknown. Alteration of respiratory control as well as dysautonomic disorders often have a fatal outcome, thus early recognition of this syndrome is essential.Material and methodsA retrospective, observational, multicenter study including all cases of ROHHAD without rapid-onset obesity diagnosed in France from 2000 to 2020.ResultsFour patients were identified. Median age at diagnosis was 8 years 10 months. Median body mass index was 17.4 kg/m2. Signs of autonomic dysfunction presented first, followed by hypothalamic disorders. All four patients had sleep apnea syndrome. Hypoventilation led to the diagnosis. Three of the four children received ventilatory support, all four received hormone replacement therapy, and two received psychotropic treatment. One child in our cohort died at 2 years 10 months old. For the three surviving patients, median duration of follow-up was 7.4 years.ConclusionROHHAD syndrome without rapid-onset obesity is a particular entity, appearing later than ROHHAD with obesity. This entity should be considered in the presence of dysautonomia disorders without brain damage. Likewise, the occurrence of a hypothalamic syndrome with no identified etiology requires a sleep study to search for apnea and hypoventilation. The identification of ROHHAD syndrome without rapid-onset obesity is a clinical challenge, with major implications for patient prognosis.

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“…Defects or damage to brain regions results in insufficient stimulation of the normal thyroid gland. Approximately 99.9% of cases of hypothyroidism are caused by primary hypothyroidism, but it depends on age 63,64 .…”

Section: Hypothyroidismmentioning

confidence: 99%

Interconnection between circadian clocks and thyroid function

et al. 2019

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Circadian rhythmicity is an approximately 24h cell-autonomous period driven by transcriptiontranslation feedback loops of specific genes, which are referred to as 'circadian clock genes'. In mammals, the central circadian pacemaker, which is located in the hypothalamic suprachiasmatic nucleus, controls peripheral circadian clocks. The circadian system regulates virtually all physiological processes, which are further modulated by changes in external environment, such as light exposure and timing of food intake. Chronic circadian disruption caused by shift work, travel across time zones or irregular sleep-wake cycles has long-term consequences on our health and is an important lifestyle factor that contributes to the risk of obesity, type 2 diabetes mellitus and cancer. Although the hypothalamic-pituitary-thyroid axis is under the control of the circadian clock via the suprachiasmatic nucleus pacemaker, daily TSH secretion profiles are disrupted in some patients with hypothyroidism and hyperthyroidism. Disruption of circadian rhythms has been recognized as a perturbation of the endocrine system and of cell cycle progression. Expression profiles of circadian clock genes are abnormal in well-differentiated thyroid cancer but not in the benign nodules or a healthy thyroid. Therefore, the characterization of the thyroid clock machinery might improve the preoperative diagnosis of thyroid cancer.

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Less known aspects of central hypothyroidism: Part 2 – Congenital etiologies

Cited by 5 publications

References 49 publications

Central hypothyroidism related to antipsychotic and antidepressant medications: an observational study and literature review

Central hypothyroidism related to antipsychotic and antidepressant medications: an observational study and literature review

ROHHAD syndrome without rapid-onset obesity: A diagnosis challenge

Interconnection between circadian clocks and thyroid function

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