36 Primary hypothyroidism was seen in 9% (n=6) cases, while central hypothyroidism
was present in only 1% in our study.
can be missed sometimes as in our second patient.
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.
TSH can't be used to monitor therapy for central hypothyroidism
is hypothyroidism that results from a deficiency in either thyrotropin-releasing hormone (TRH) or thyrotropin (also called thyroid stimulating hormone, or TSR).
was diagnosed based on the low free T4 results with a normal TSH.
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).
, caused by pituitary-based deficiencies of thyrotropin-stimulating hormone or thyrotropin-releasing hormone, will not be discussed.
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.
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%).
3) As in this patient, central hypothyroidism
may herald significant pituitary disease, and it is often overlooked for several years.
Hypothyroidism observed in association with Targretin capsules appears to be due to a thyroid axis alteration consistent with a temporary central hypothyroidism
(suppression of thyroid stimulating hormone).