Adriaanse R, Romjin JA, Endert E, et al: The nocturnal thyroid stimulating hormone surge is absent in overt, present in mild primary and equivocal in central hypothyroidism
The majority of the cases have either a genetic or structural basis for central hypothyroidism
Additionally, patients with results suggestive of central hypothyroidism
, or an inadequate response from the hypothalamic-pituitary-thyroid axis, went uninvestigated.
After investigations, the patient was confirmed to have central hypothyroidism
, secondary adrenal insufficiency and GH deficiency.
If an organic lesion is excluded by CT/MRI in the child with central hypothyroidism
, GH testing can be pursued, provided the hypothyroidism is first treated for 6 to 12 weeks.
It is not sufficient for assessing hospitalized patients or when central hypothyroidism
is present or suspected (central hypothyroidism
is due to a decrease in the secretion of TSH from the pituitary gland).
However, in patients with hypothyroidism without a high TSH, such as those with central hypothyroidism
, the diagnosis might remain inapparent.
is an exceedingly rare form of hypothyroidism that results from a variety of conditions affecting the hypothalamus and the pituitary gland.
At 300 mg/m2/day, adverse events (AEs) of greater than or equal to 15 percent incidence, at least possibly related to treatment were hyperlipemia (primarily hypertriglyceridemia, 79 percent), hypercholesteremia (32 percent), central hypothyroidism
(29 percent), headache 25 (percent), and asthenia (16 percent).
Its use in differentiating causes of central hypothyroidism
(pituitary vs hypothalamic) has been questioned.
TSH below normal TSH above normal Primary hyperthyroidism Primary hypothyroidism Pituitary/hypothalamic disease Pituitary thyrotroph adenoma with central hypothyroidism
Pituitary resistance to thyroid hormone (central hyperthyroidism) Generalized thyroid hormone resistance Prolonged thyrotroph cell Thyrotoxicosis from overly rapid suppression after recent correction of severe hypothyroidism hyperthyroidism in euthyroid with parenteral [T.
Adverse events experienced by more than 10% of patients at least possibly related to treatment at the 300 mg/m2/day dose level included hyperlipemia (primarily hypertriglyceridemia, 82%), hypercholesteremia (30%), central hypothyroidism
(29%), headache (20%), asthenia (16%), pruritus (13%), leukopenia (11%), rash (11%) and skin disorder (11%).