TY - JOUR
T1 - Adolescent secondary amenorrhea
T2 - Association with hypothalamic hypothyroidism
AU - Kramer, Michael S.
AU - Kauschansky, Arieh
AU - Genel, Myron
N1 - Funding Information:
From the Section of Pediatric Endocrinology, Department of Pediatrics, Yale University School of Medicine, and Yale-New Haven Hospital Presented in part at the annual meeting of the Society for Pediatric Research, April 28, 1978, in New York City. Supported by Grant RR-125 from the General Clinical Research Centers Program, Division of Research Resources, National Institutes of Health. Dr_ Kauschansk)' was supported by Training Grant H D-O0t 77-11f rom the National Institutes of Health. Reprint address: The Montreal Children's Hospital 2300 Tupper St., Montreal P.Q. H3H IP3, Canada.
PY - 1979/2
Y1 - 1979/2
N2 - In adolescent girls, secondary amenorrhea can result from a variety of physiologic and psychologic disturbances. Previous reports associating amenorrhea and primary hypothyroidism have not distinguished between the alternative etiologic roles of thyroxine deficiency and hyperprolactinemia. We have evaluated two girls with secondary amenorrhea who had clinical and chemical evidence of hypothyroidism. Both had low basal T4 values (0.8 and 3.8 μg/dl), calculated free T4 (0.1 and 0.7 ng/dl), and T3 (51 and 81 ng/dl). Both had undetectable basal TSH with normal TSH response to TRH. Basal FSH and LH values were normal, as was the response to LHRH. Basal prolactin levels were 6 and 14 ng/ml, respectively, and both girls had growth hormone responses of ≥15 ng/ml in response to insulin-induced hypoglycemia. Pituitary-adrenal function and reserve were also normal. In neither patient was there any historical, physical, or laboratory features compatible with anorexia nervosa. After treatment with 1-thyroxine, both girls had a resumption in menses. These two adolescent girls thus appear to have isolated hypothalamic hypothyroidism. The associated secondary amenorrhea demonstrates that thyroid deficiency alone, without hyperprolactinemia, can interfere with normal hypothalamic-pituitary-ovarian function.
AB - In adolescent girls, secondary amenorrhea can result from a variety of physiologic and psychologic disturbances. Previous reports associating amenorrhea and primary hypothyroidism have not distinguished between the alternative etiologic roles of thyroxine deficiency and hyperprolactinemia. We have evaluated two girls with secondary amenorrhea who had clinical and chemical evidence of hypothyroidism. Both had low basal T4 values (0.8 and 3.8 μg/dl), calculated free T4 (0.1 and 0.7 ng/dl), and T3 (51 and 81 ng/dl). Both had undetectable basal TSH with normal TSH response to TRH. Basal FSH and LH values were normal, as was the response to LHRH. Basal prolactin levels were 6 and 14 ng/ml, respectively, and both girls had growth hormone responses of ≥15 ng/ml in response to insulin-induced hypoglycemia. Pituitary-adrenal function and reserve were also normal. In neither patient was there any historical, physical, or laboratory features compatible with anorexia nervosa. After treatment with 1-thyroxine, both girls had a resumption in menses. These two adolescent girls thus appear to have isolated hypothalamic hypothyroidism. The associated secondary amenorrhea demonstrates that thyroid deficiency alone, without hyperprolactinemia, can interfere with normal hypothalamic-pituitary-ovarian function.
UR - http://www.scopus.com/inward/record.url?scp=0018330411&partnerID=8YFLogxK
U2 - 10.1016/S0022-3476(79)80851-3
DO - 10.1016/S0022-3476(79)80851-3
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AN - SCOPUS:0018330411
SN - 0022-3476
VL - 94
SP - 300
EP - 303
JO - Journal of Pediatrics
JF - Journal of Pediatrics
IS - 2
ER -