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Thyrotroph hyperplasia
  1. Philip C Johnston1,
  2. Peter K Ellis2,
  3. Steven J Hunter1
  1. 1Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, UK
  2. 2Department of Radiology, Royal Victoria Hospital, Belfast, UK
  1. Correspondence to Dr Steven J Hunter, Regional Centre for Endocrinology & Diabetes, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, UK; steven.hunter{at}belfasttrust.hscni.net

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Introduction

Thyrotroph hyperplasia has been reported in the context of primary hypothyroidism,1 most often observed in the situation of protracted elevated thyroid stimulating hormone (TSH) levels, which can result in pituitary enlargement. Provided there is no visual field deficit, thyroxine replacement is required as the first line treatment. We report a case of pituitary enlargement due to thyrotroph hyperplasia observed in a patient with noncompliance of Levothyroxine.

Case

A 20-year-old woman with a 6-year history of hypothyroidism presented with daily frontal headaches and menorrhagia. She had irregular compliance with her current prescription of Levothyroxine 200 mcg daily and recent thyroid function tests prior to presentation revealed hypothyroidism with significantly elevated …

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