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Endocr Pract. 2006 Sep-Oct;12(5):572.

Reversible subclinical hypothyroidism in the presence of adrenal insufficiency.

Author information

  • 1Department of Pediatrics, Division of Pediatric Endocrinology and Metabolism, The Children's Hospital of Alabama, University of Alabama School of Medicine, Birmingham, Alabama 35233, USA.

Abstract

OBJECTIVE:

To describe 3 different scenarios of reversible hypothyroidism in young patients with adrenal insufficiency.

METHODS:

We present 3 case reports of patients with adrenal insufficiency--one with delayed puberty, the second with type 1 diabetes and poor weight gain, and the third with hypoglycemia-related seizures and glucocorticoid deficiency--who had biochemical evidence of hypothyroidism.

RESULTS:

Our first patient (case 1) initially had a mildly elevated thyrotropin (thyroid-stimulating hormone or TSH) level and a normal free thyroxine (FT4) level that, on follow-up assessment, had progressed to persistent mild elevation of TSH and low FT4 concentration. The other 2 patients (cases 2 and 3) had low FT4 and mildly elevated TSH values at the time of diagnosis of adrenal insufficiency. In all 3 patients, the results of thyroid function tests normalized with use of physiologic doses of adrenal hormone replacement therapy, without thyroid hormone replacement. All 3 patients remained euthyroid after 4, 3, and 1 year of follow-up, respectively.

CONCLUSION:

These observations add insights into the complexities of the thyroadrenal interactions. These examples are important because thyroid hormone replacement in the setting of adrenal insufficiency could be unwarranted.

PMID:
17002934
[PubMed - indexed for MEDLINE]
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