{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T05:00:00Z","timestamp":1794459600716,"version":"4.9.1"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T00:00:00Z","timestamp":1707091200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T00:00:00Z","timestamp":1707091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100007833","name":"Hamad Medical Corporation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007833","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Thyroid Res"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Coexistence of TSH-secreting pituitary adenoma (TSHoma) and Graves\u2019 disease (GD) is rare and complicates the management decision.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We present a case of the co-existence of TSHoma and GD. In addition, we systematically searched articles describing TSHoma and GD in the same patient published until 20th March 2023, using Pubmed, Scopus and Embase.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 46-year-old man presented with symptoms of thyrotoxicosis. His thyroid function tests showed serum TSH 3.35 (reference range 0.3\u20134.2) mIU\/L, FT3 19.7 (3.7\u20136.4) pmol\/L, and FT4 68.9 (11-23.3) pmol\/L. The serum TSH receptor antibody was 11.5 mIU\/L (positive at \u2265\u20091.75 mIU\/L). Pituitary magnetic resonance imaging showed macroadenoma compressing the optic chiasm. The patient underwent trans-sphenoidal resection of pituitary adenoma. Postoperatively, he remained on maintenance carbimazole and octreotide.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Fourteen articles comprising 15 patients were identified from the systemic search. A total of 16 patients (including the current case) were included in the systematic review. The mean (\u00b1\u2009SD) age at diagnosis was 41\u2009\u00b1\u200913.6 years. The majority were females (75%). The median (IQR) TSH was 1.95 (0.12\u20135.5) mIU\/L, the median (IQR) free T3 was 11.7 (7.6\u201319.7) pmol\/L and the median (IQR) free T4 level was 47.6 (33.3\u201364.4) pmol\/L. Ten (76.9%) patients had positive TSH receptor antibody levels. 84.6% had pituitary macroadenoma. Pituitary surgery was performed in 12 (75%) patients. At the last follow-up, 4 (25%) patients had complete resolution of symptoms after pituitary surgery, 3 (18.7%) were on maintenance treatment with thionamides for GD, 1 (6.25%) on beta-blockers and 1 (6.25%) on somatostatin analog.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>TSHoma and GD can co-exist, and it is essential to identify this rare association as it can significantly impact treatment strategies.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13044-023-00184-2","type":"journal-article","created":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T01:15:17Z","timestamp":1707095717000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Clinical characteristics and outcomes of patients with TSH-secreting pituitary adenoma and Graves\u2019 disease - a case report and systematic review"],"prefix":"10.1186","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1583-1539","authenticated-orcid":false,"given":"Adeel Ahmad","family":"Khan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahd I.","family":"Ibrahim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fateen","family":"Ata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bara","family":"Wazwaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Abdulalim","family":"Hanoun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sirajeddin","family":"Belkhair","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaina Seros","family":"Rohani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeinab","family":"Dabbous","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,5]]},"reference":[{"issue":"4","key":"184_CR1","doi-asserted-by":"publisher","first-page":"R183","DOI":"10.1530\/EJE-16-1029","volume":"177","author":"A Tj\u00f6rnstrand","year":"2017","unstructured":"Tj\u00f6rnstrand A, Nystr\u00f6m HF. 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The systematic review does not require ethical approval as it uses previously published data and does not involve endangering participant rights.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient before the publication of the case and the associated images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"This manuscript is an original work and is not submitted or under consideration for publication elsewhere. The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"3"}}