Resumen

Inappropriate thyrotropin secretion in the presence of a pituitary adenoma: a complex differential diagnosis made easier by thorough clinical evaluation - two teaching case reports

VOLUMEN 5 - NÚMERO 1 / Enero - Marzo (Casos clí­nicos / Clinical cases)

Claudia Ramírez-Rentería, Grupo de Trabajo en Neuroendocrinología, Sociedad Mexicana de Nutrición y Endocrinología A.C., Ciudad de México; Unidad de Investigación Médica en Enfermedades Endocrinas, Unidad Médica de Alta Especialidad, Hospital de Especialidades Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México; México
Miriam Sánchez, Endocrinología, UMAE Siglo XXI IMSS, Instituto Mexicano del Seguro Social, México
Luis Vega, Endocrinología, UMAE Siglo XXI IMSS, Instituto Mexicano del Seguro Social, México
Elida Espinosa, Endocrinología, Sanatorio Ángeles de Tehuacán, Puebla, México
Eric Zepeda, Neurocirugía, UMAE Siglo XXI IMSS, Instituto Mexicano del Seguro Social, México

Inappropriate thyrotropin secretion is a rare laboratory finding that may be related to multiple differential diagnosis. The presence of a pituitary adenoma usually relates to a thyroid-stimulating hormone (TSH) producing adenoma; however, the possibility of incidentalomas and other tumors should be considered. Differential diagnosis requires careful clinical evaluation and family history evaluation, especially when the most complicated tests are unavailable. We present two cases, one with a TSH producing adenoma and other with a non-functioning pituitary adenoma and thyroid hormone resistance that was diagnosed using the available clinical data, showing that not all the tests are necessary to provide adequate treatment if the clinical tools are considered.

Palabras clave: Inappropriate thyroid-stimulating hormone. Adenoma. Pituitary. Hormone resistance.