RT Journal
A1 Cohen K, Felig P
T1 PRimary hypothyroidism and the pituitary
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 1979
FD August 1
VO 139
IS 8
SP 855
OP 856
DO 10.1001/archinte.1979.03630450009004
UL http://dx.doi.org/10.1001/archinte.1979.03630450009004
AB The availability of radioimmunoassay procedures for the measurement of thyroid-stimulating hormone (TSH) has simplified the differential diagnosis of primary vs secondary hypothyroidism. An elevation of the serum TSH level points to primary failure of the thyroid gland as the basis of the hypothyroidism. However, primary hypothyroidism may secondarily affect a variety of aspects of pituitary function, so that clinical tests evaluating pituitary hormone secretion may lose their diagnostic value.1 Impaired secretion of growth hormone, delayed gonadotropin responses to luteinizing hormone-releasing factor, decreased adrenocorticotropic hormone release, and increased basal and stimulated prolactin levels have been reported in primary hypothyroidism.1 Two additional findings that may be of particular clinical importance are the occurrence of amenorrhea-galactorrhea2 and sellar enlargement, suggesting the presence of a pituitary tumor.3The term "amenorrhea-galactorrhea syndrome" has taken on a new meaning in recent years. Increasingly sophisticated endocrine, radiological, and neurosurgical skills have decreased the