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Case Report | Paediatrics | Volume 15 Issue 8, August 2026 | Pages: 1428 - 1429 | India
Chronic Hypothyroidism Induced Pituitary Hyperplasia: A Reversible Cause of Pituitary Enlargement in Adolescence
Abstract: Background: Primary hypothyroidism is an important and often overlooked endocrine cause of short stature and delayed puberty in adolescents. Chronic untreated hypothyroidism may lead to pituitary thyrotroph hyperplasia, which can radiologically mimic pituitary macroadenoma. Differentiating between these entities is critical since hypothyroidism-induced pituitary hyperplasia resolves with thyroid hormone replacement, whereas macroadenomas may require surgical intervention. Clinical Description: We report a 13-year-old female who presented with short stature, delayed puberty, generalized edema, and recurrent morning vomiting. She was prepubertal (SMR stage I) with height and weight corresponding to 6- and 8-year equivalents, respectively. Management: Investigations revealed markedly elevated TSH (933.62 mIU/L) and low FT4 (<0.42 ng/dL), consistent with severe primary hypothyroidism. Gonadotropins (FSH 6.7 IU/L; LH 0.1 IU/L) were prepubertal. MRI brain with pituitary protocol demonstrated a diffusely bulky, dumbbell-shaped pituitary gland (height 11.8 mm) showing homogeneous post-contrast enhancement, suggestive of pituitary hyperplasia versus macroadenoma. Endocrinology evaluation confirmed hypothyroidism-induced pituitary hyperplasia. The patient was started on step-up levothyroxine therapy (25 mcg ? 37.5 mcg ? 50 mcg OD maintenance). Conclusion: Chronic primary hypothyroidism should be considered in adolescents presenting with growth failure, pubertal delay, and pituitary mass-like lesions. Early recognition and appropriate thyroid hormone replacement lead to complete regression of pituitary hyperplasia and prevent unnecessary surgical interventions.
Keywords: Primary hypothyroidism, pituitary hyperplasia, short stature, delayed puberty, adolescent endocrinology
How to Cite?: Dr. Smrati Jain, Dr. Anjali, "Chronic Hypothyroidism Induced Pituitary Hyperplasia: A Reversible Cause of Pituitary Enlargement in Adolescence", Volume 15 Issue 8, August 2026, International Journal of Science and Research (IJSR), Pages: 1428-1429, https://www.ijsr.net/getabstract.php?paperid=SR26820234633, DOI: https://dx.doi.org/10.21275/SR26820234633