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目的探讨儿童甲状腺功能减退导致垂体增生的临床特点、发病机制和治疗。方法报告4例儿童继发于甲状腺功能减退的垂体增生病例,并结合文献进行分析。结果4例儿童均表现为TSH和PRL增高及FT3和FT4的减少、垂体增大。CT和MRI冠状扫描显示垂体高度1．6～2．3 cm,3例服用甲状腺素后垂体肿物消失及内分泌紊乱恢复正常；另1例手术行肿物大部切除,病理报告“垂体细胞瘤样增生”,服用甲状腺素及强的松,3个月后复查MRI显示为部分性空蝶鞍。结论当患儿有TSH和PRL增高伴垂体增大时,首先应考虑为“垂体增生”,仅服用甲状腺素治疗即可获得痊愈。
Objective To investigate the clinical features, pathogenesis and treatment of pituitary hyperplasia in children with hypothyroidism. Methods Four cases of children with hypothyroidism secondary to pituitary hyperplasia were reported and analyzed. Results All the 4 children showed elevated TSH and PRL, decreased FT3 and FT4, and increased pituitary. CT and MRI coronal scan showed pituitary height 1.6 ~ 2.3 cm, 3 cases of thyroid hormone disappeared and endocrine disorders disappeared back to normal; the other 1 case of tumor resection in most cases, the pathological report of “pituitary tumor Like hyperplasia ”, taking thyroxine and prednisone, 3 months after the review MRI showed partial empty sella. Conclusion When children with elevated TSH and PRL accompanied by increased pituitary, the first should be considered as “pituitary hyperplasia,” only treated with thyroid hormone can be cured.