Table 3 Demographic characteristics, clinical characteristics and outcomes of patients with simultaneous presentation with TSHoma and GD
Variable | Result |
|---|---|
Number of patients | 8 |
Age in years (Mean +/- SD) | 47.25 +/- 8.6 |
Gender, N (%) | |
Male | 2 (25) |
Female | 6 (75) |
Symptoms and signs, N (%) | |
Palpitations | 4 (50) |
Heat intolerance | 4 (50) |
Weight loss | 1 (12.5) |
Sweating | 1 (12.5) |
Tremors | 4 (50) |
Exophthalmos | 4 (50) |
Goiter | 2 (25) |
Headache | 1 (12.5) |
Visual field defect | 2 (25) |
TSH (Mean +/- SD, mIU/L) | 4.3 +/- 3.3 |
FT3 (Median [IQR], pmol/ml) | 9.9 (6.6–19.7) |
FT4 (Mean +/- SD, pmol/L) | 45.5 +/- 13.6 |
Antibodies, N (%) | |
TSH receptor Ab (N = 7) | 6 (85.7) |
Thyroid stimulation Ab (N = 1) | 1 (100) |
Anti TPO Ab (N = 4) | 3 (75) |
Anti TG Ab (N = 3) | 2 (66.6) |
High SHBG (N = 2) | 2 (100) |
Alpha TSH/TSH molar ratio (N = 2) | |
> 1 | 2 (100) |
TSH suppression after octreotide (N = 2) | 2 (100) |
Thyroid uptake scan (N = 5) | |
diffusely increased uptake | 4 (80) |
Hypoactive nodule | 1 (20) |
Pituitary imaging (N = 8) | |
Macroadenoma | 7 (87.5) |
Not mentioned | 1 (12.5) |
Mean (SD) size of the adenoma (cm) | 1.6 +/- 0.8 |
TRH Stimulation testing (N = 5) | |
Normal response | 2 (40) |
Abnormal response | 3 (60) |
Somatostatin analogue prior to surgery (N = 8) | 3 (37.5) |
Anti-thyroid drug initiation leading to worsening. N = 4 | 2 (50) |
Pituitary surgery was performed. | 7 (87.5) |
Pituitary irradiation | 1 (12.5) |
Immunostaining positive for TSHoma (N = 6) | 5 (83.3) |
Final outcome (N = 8) | |
On maintenance treatment for GD | 2 (25) |
On maintenance somatostatin analogue | 1 (12.5) |
Complete symptoms resolution after pituitary surgery | 2 (25) |
Has residual mass with normal TSH | 1 (12.5) |
Not mentioned | 2 (25) |