Primary Hypothyroidism

THE ASSOCIATION between primary hypothyroidism in adults and pituitary enlargement was first described in 1892.1Similar cases have been reported recently.2-5They have been characterized by enlargement or alteration in contour of the sella turcica. A decrease in pituitary size following thyroxine (T4) replacement therapy has been reported by Jawadi et al,6who demonstrated regression of suprasellar expansion with pneumoencephalography, and by Pita et al,7who reported disappearance of a pituitary tumor on computed tomographic (CT) scan. A case of suprasellar extension of pituitary tissue in a patient with severe hypothyroidism has been easily demonstrated by CT scanning using both transverse and coronal sections. The unusual feature of the case is that no abnormalities were noted on sella tomography. With supervised T4replacement, the CT changes completely resolved within two months. Report of a Case A 23-year-old woman was admitted for right optic neuritis.