Clinical Original Article
Syndrome of resistance to thyroid hormone and thyrotropin-secreting pituitary adenoma: Case series study
Liu Longfu, Peng Ning, Jiang Tiejian
Published 2022-12-25
Cite as Chin J Endocrinol Metab, 2022, 38(12): 1057-1062. DOI: 10.3760/cma.j.cn311282-20211209-00786
Abstract
ObjectiveTo outline clinical features in syndrome of resistance to thyroid hormone(RTH) and thyrotropin-secreting pituitary adenoma(TSH adenoma) based on a case series, and to assess the value of octreotide suppression test and high-dose dexamethasone suppression test(HDDST) in differentiating the two diseases.
MethodsA total of 22 cases with RTH and TSH adenoma clinically diagnosed in Xiangya Hospital of Central South University from October 2010 to December 2021 were retrieved. The clinical characteristics of the two diseases and results to different tests were analyzed and summarized.
Results(1) The tumors in TSH adenoma patients were larger than those with RTH complicated with pituitary mass, which presented chiasmatic compression on images(P<0.05). (2) In octreotide suppression test, thyrotropin(TSH) inhibition rate in RTH patients was lower than that in TSH adenoma patients(P<0.05). In HDDST, TSH inhibition rate was higher in patients with RTH than in patients with TSH adenoma(P<0.05). (3) The TSH inhibition rate was calculated by receiver operating characteristic(ROC) curve. The sensitivity and specificity of octreotide suppression test were 91.9% and 55.6%, respectively, and the threshold value of TSH inhibition rate was 64.24%. The sensitivity and specificity of HDDST were 54.4% and 89.0%, respectively, and the threshold value of TSH inhibition rate was 65.73%.The combined sensitivity and specificity of the two tests were 77.8% and 90.9%, indicating better diagnostic value(P<0.05).
ConclusionsThe combination of octreotide suppression test and HDDST is of clinical value in differentiating RTH from TSH adenoma. TSH adenoma is more aggressive than that of pituitary adenoma with RTH.
Key words:
Syndrome of resistance to thyroid hormone; Thyrotropin-secreting pituitary adenoma; Octreotide suppression test; High-dose dexamethasone suppression test
Contributor Information
Liu Longfu
Department of Endocrinology, Xiangya Hospital of Central South University, Changsha 410005, China
Liu Longfu is working on the Department of Endocrinology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang 441000, China
Peng Ning
Department of Endocrinology, Xiangya Hospital of Central South University, Changsha 410005, China
Jiang Tiejian
Department of Endocrinology, Xiangya Hospital of Central South University, Changsha 410005, China
