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dc.contributor.authorMacfarlane, I Aen
dc.contributor.authorShalet, Stephen Men
dc.contributor.authorBeardwell, Colin Gen
dc.contributor.authorApplegate, Gen
dc.contributor.authorRobinson, E Len
dc.contributor.authorSutton, M Len
dc.date.accessioned2014-12-23T15:00:31Z
dc.date.available2014-12-23T15:00:31Z
dc.date.issued1983-02
dc.identifier.citationExternal pituitary irradiation as a cause of TRH deficiency in patients with pituitary adenomas. 1983, 18 (2):201-9 Clin Endocrinolen
dc.identifier.issn0300-0664
dc.identifier.pmid6406112
dc.identifier.doi10.111/j.1365-2265.1983.tb03203.x
dc.identifier.urihttp://hdl.handle.net/10541/337612
dc.description.abstractThe influence of external pituitary irradiation (XRT) on thyrotroph function and PRL secretion was studied in twenty-five patients with pituitary adenomas, of whom eight had acromegaly. Twenty-one patients had undergone subtotal operative removal of their adenomas 8-190 weeks (median 12 weeks) before XRT. Following irradiation there was a significant reduction in peak serum TSH levels in response to i.v. TRH (P less than 0.05, compared with before XRT). Peak TSH levels returned to normal at 3 months. Similarly a transient reduction in TRH-stimulated beta-TSH release was observed. Serum T3 and T4 concentrations also fell after XRT, the levels at 3 months being significantly lower than control values (P less than 0.02), though no difference was seen at 6 and 12 months. A delayed (hypothalamic) serum TSH response to TRH (60 greater than 20-min level) developed at 6 months. In contrast, PRL concentrations (basal and TRH stimulated) were not altered during the 12 months following XRT. These findings demonstrate that thyrotroph function can be transiently impaired following external pituitary irradiation. None of the patients studied required T4 replacement therapy. The development of a delayed TSH response to i.v. TRH may indicate endogenous TRH deficiency. It was not associated with supra-sellar tumour enlargement in our patients and may be due to hypothalamic damage by irradiation.
dc.language.isoenen
dc.rightsArchived with thanks to Clinical endocrinologyen
dc.subject.meshAdenoma
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshFemale
dc.subject.meshHumans
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshPituitary Irradiation
dc.subject.meshPituitary Neoplasms
dc.subject.meshProlactin
dc.subject.meshThyrotropin
dc.subject.meshThyrotropin-Releasing Hormone
dc.subject.meshThyroxine
dc.subject.meshTriiodothyronine
dc.titleExternal pituitary irradiation as a cause of TRH deficiency in patients with pituitary adenomas.en
dc.typeArticleen
dc.contributor.departmentDepartments of Endocrinology and Radiotherapy, Christie Hospital and Holt Radium Institute, Manchester M20 9BXen
dc.identifier.journalClinical Endocrinologyen
html.description.abstractThe influence of external pituitary irradiation (XRT) on thyrotroph function and PRL secretion was studied in twenty-five patients with pituitary adenomas, of whom eight had acromegaly. Twenty-one patients had undergone subtotal operative removal of their adenomas 8-190 weeks (median 12 weeks) before XRT. Following irradiation there was a significant reduction in peak serum TSH levels in response to i.v. TRH (P less than 0.05, compared with before XRT). Peak TSH levels returned to normal at 3 months. Similarly a transient reduction in TRH-stimulated beta-TSH release was observed. Serum T3 and T4 concentrations also fell after XRT, the levels at 3 months being significantly lower than control values (P less than 0.02), though no difference was seen at 6 and 12 months. A delayed (hypothalamic) serum TSH response to TRH (60 greater than 20-min level) developed at 6 months. In contrast, PRL concentrations (basal and TRH stimulated) were not altered during the 12 months following XRT. These findings demonstrate that thyrotroph function can be transiently impaired following external pituitary irradiation. None of the patients studied required T4 replacement therapy. The development of a delayed TSH response to i.v. TRH may indicate endogenous TRH deficiency. It was not associated with supra-sellar tumour enlargement in our patients and may be due to hypothalamic damage by irradiation.


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