Table 2 Demographic, clinical/laboratory characteristics, and outcomes of patients with TSHoma and GD
Variable | Result |
|---|---|
Number of patients (N) | 16 |
Age in years (Mean +/- SD) | 41 +/- 13.6 |
Gender, N (%) | |
Male | 4 (25) |
Female | 12 (75) |
Symptoms and signs, N (%) | |
Palpitations | 8 (50) |
Heat intolerance | 6 (37.5) |
Weight loss | 6 (37.5) |
Sweating | 4 (25) |
Tremors | 7 (43.7) |
Exophthalmos | 4 (25) |
Goiter | 7 (43.7) |
Headache | 1 (6.2) |
Visual field defect | 3 (18.7) |
Diagnosis | |
GD and TSHoma co-existing | 8 (50) |
GD diagnosed first | 4 (25) |
TSHoma diagnosed first | 4 (25) |
TSH (Median [IQR], mIU/L) | 1.95 (0.12–5.5) |
FT3 (Median [IQR], pmol/L) | 11.7 (7.6–19.7) |
FT4 (Median [IQR], pmol/L) | 47.6 (33.5–64.4) |
Antibodies positive, N (%) | |
TSH receptor Ab (N = 13) | 10 (76.9) |
Thyroid stimulating Ab (N = 3) | 2 (66.6) |
Anti TPO Ab (N = 7)Anti Tg Ab Ab (N = 7) | 4 (57.1) |
4 (57.1) | |
High SHBG (N = 3) | 3 (100) |
Alpha-TSH/TSH molar ratio (N = 4) | |
< 1 | 1 (25) |
> 1 | 3(75) |
TSH suppression after octreotide (N = 4) | 4 (100) |
Thyroid uptake scan (N = 8) | |
Diffusely increased uptake | 7 (87.5) |
Hypoactive nodule | 1 (12.5) |
Pituitary imaging (N = 13) | |
Macroadenoma | 11 (84.6) |
Microadenoma | 2 (15.4) |
Mean (SD) size (cm) | 1.4 +/- 0.67 |
TRH Stimulation testing (N = 8) | |
Normal response | 1 (12.5) |
Abnormal response | 7 (87.5) |
Somatostatin analog prior to surgery (N = 16) | 4 (25) |
Anti-thyroid drug initiation leading to worsening (N = 11) | 3 (27.3) |
Pituitary surgery performed (N = 16) | 12 (75) |
Immunostaining positive for TSHoma (N = 10) | 8 (80) |
Final outcome (N = 16) | |
On maintenance treatment for GD | 3 (18.7) |
On maintenance somatostatin analogue | 1 (6.25) |
On maintenance betablocker only | 1 (6.25) |
Complete symptoms resolution after pituitary surgery | 4 (25) |
Not mentioned | 6 (37.5) |