Abstract
The nocturnal TSH surge (ΔTSHn) was studied in 23 control children (group I), 33 with hypothalamic pituitary disease (group II) and 12 patients with primary hypothyroidism, 10 with mild (group III) and 2 with overt hypothyroidism. TSH was measured by IRMA; TSH was calculated as the % increase in the night TSH over day TSH. The results were (X±SE).
*p > 0.01 vs group I.A ΔTSHn was found in 16/33 patients of group II (48.5%), in 10 of them the TRH test was normal; in the remaining 17 with ΔTSHn present the TRH test was normal in 9. Group II was divided into patients who were hypothyroid FT4 < 0.7 ng/dl (group III) or euthyroid FT4>0.8 ng/dl (group II2).II1, n=9,Δ TSHn:50.3±15.3%, deficient in 7/9 (77%), TRH test was abnormal in 5/9 (56%); 112, n=24, Δ TSHn: 110.9±21.5%, deficient in 9/24 (37.5%),. TRH test abnormal in 10/24 (62.5%). The TSHn was found deficient in 77% of patients with central hypothyroidism, normal in mild hypothyroidism but absent in overt hypothyroidism. We conclude thatΔTSHn did not provide a complete discrimination between euthyroidism and central hypothyroidism. The ΔTSHn plays and important role in the pathophysiology of central hypothyroidism but many others factors may be implicated.
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Gruñeiro, L., Chiesa, A., Martinez, A. et al. 18 NOCTURNAL TSH SURGE IN CHILDREN WITH HYPOTHALAMIC PITUITARY DISORDERS AND PRIMARY HYPOTHYROIDISM. Pediatr Res 36, 675 (1994). https://doi.org/10.1203/00006450-199411000-00042
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DOI: https://doi.org/10.1203/00006450-199411000-00042