PRIMARY HYPOTHYROIDISM AND OVARIAN ACTIVITY EVIDENCE FOR AN OVERLAP IN THE SYNTHESIS OF PITUITARY GLYCOPROTEINS

Abstract

A 14 yr old girl presented with precocious sexual development, galactorrhea and symptoms and signs suggestive of hypothyroidism. On physical examination, a tumor was found in the lower abdomen. Serum gonadotropins, especially luteinizing hormone [lutropin], serum thyroid stimulating hormone [thyrotropin] and prolactin were elevated. Measurement of thyroid hormones [thyroxine and triiodothyronine] and additional thyroid function tests confirmed the diagnosis of primary hypothyroidism. Ultrasound investigation revealed the mass in the lower abdomen to be of a cystic nature and to originate from the right ovary. Following thyroid substitution therapy all symptoms disappeared, biochemical and hormonal abnormalities returned to normal and the ovarian size decreased to normal. A hypothesis is presented for non-specific pituitary glycoprotein hormone synthesis secondary to the hypothyroidism, as the cause of the syndrome.