{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:27:25Z","timestamp":1790310445889,"version":"4.1.0"},"reference-count":62,"publisher":"Walter de Gruyter GmbH","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Pituitary hyperplasia secondary to primary longstanding hypothyroidism has been reported in the literature in adults and rarely in children.<\/jats:p><jats:p>Here we present the clinical presentation and diagnostic procedures in eight children with pituitary hyperplasia due to autoimmune thyroiditis, highlighting common findings, such as growth delay, fatigue or gaining weight, but also exceptional findings such as pericardial effusion, rhabdomyolysis, isolated hypertrichosis, and Van Wyk-Grumbach syndrome, which have rarely or never been described.<\/jats:p><jats:p>Surprisingly no thyroid enlargement was detected. We discuss the unusual presenting signs of autoimmune thyroiditis that should raise the suspicion of pituitary hyperplasia. We suggest that a more elaborate clinical assessment and even modification of the diagnostic approach to autoimmune thyroiditis is needed in order to avoid its serious complications.<\/jats:p>","DOI":"10.1515\/jpem-2015-0157","type":"journal-article","created":{"date-parts":[[2015,11,20]],"date-time":"2015-11-20T15:04:14Z","timestamp":1448031854000},"source":"Crossref","is-referenced-by-count":13,"title":["Diagnostic approach in children with unusual symptoms of acquired hypothyroidism. When to look for pituitary hyperplasia?"],"prefix":"10.1515","volume":"29","author":[{"given":"Mirjana","family":"Kocova","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolina","family":"Zdraveska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rozana","family":"Kacarska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Kochova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","reference":[{"key":"ref591","first-page":"141","article-title":"case of hypothyroidism mimicking acute coronary syndrome Imaging","volume":"22","author":"Gunduz","year":"2006","journal-title":"Int J"},{"key":"ref571","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1515\/jpem-2012-0249","article-title":"AN syndrome and pituitary hyperplasia in an adolescent secondary to thyroiditis","volume":"26","author":"Cebeci","year":"2013","journal-title":"J Pediatr Endocrinol Metab"},{"key":"ref221","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1515\/jpem-2012-0249","article-title":"AN syndrome and pituitary hyperplasia in an adolescent secondary to thyroiditis","volume":"26","author":"Cebeci","year":"2013","journal-title":"J Pediatr Endocrinol Metab"},{"key":"ref351","first-page":"138","article-title":"hyperplasia resulting from primary hypothyroidism mimicking macroadenomas","volume":"13","author":"Kattner","year":"1999","journal-title":"Young Pituitary J Neurosurg"},{"key":"ref631","first-page":"416","article-title":"Syndrome of precocious menstration and galactorrhea in juvenile hypothyroidism : an example of hormonal overlap in pituitary feedback","author":"van","year":"1960","journal-title":"J Pediatr"},{"key":"ref411","article-title":"MR assessment of pituitary gland morphology in healthy volunteers : age - and gender - related differences","volume":"13","author":"Doraiswamy","year":"1992","journal-title":"Am J Neuroradiol"},{"key":"ref641","article-title":"MB wyk and grumbach syndrome : an unusual case and review of the literature","volume":"24","author":"Durbin","year":"2011","journal-title":"J Pediatr Gynecol"},{"key":"ref01","first-page":"138","article-title":"hyperplasia resulting from primary hypothyroidism mimicking macroadenomas","volume":"13","author":"Kattner","year":"1999","journal-title":"Young Pituitary J Neurosurg"},{"key":"ref531","first-page":"122","article-title":"Goitrous autoimmune thyroiditis in a pediatric population : a longitudinal study","author":"Gopalakrishnan","year":"2008","journal-title":"Pediatrics"},{"key":"ref291","article-title":"MB wyk and grumbach syndrome : an unusual case and review of the literature","volume":"24","author":"Durbin","year":"2011","journal-title":"J Pediatr Gynecol"},{"key":"ref471","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1007\/s12098-013-1221-6","article-title":"AR hypothyroidism presenting as pituitary hyperplasia","author":"Namburi","year":"2014","journal-title":"Indian J Pediatr"},{"key":"ref381","first-page":"61","article-title":"Primary hypothyroidism in a child mimicking a pituitary macroadenoma","volume":"63","author":"Hopper","year":"2005","journal-title":"Horm Res"},{"key":"ref211","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1080\/07435800500371706","article-title":"Serum creatine kinase levels in overt and subclinical hypothyroidism","volume":"31","author":"Hekimsoy","year":"2005","journal-title":"Endocr Res"},{"key":"ref421","first-page":"36","article-title":"of normal pituitary gland on MR imaging age and sex differentiation Assist","volume":"14","author":"Suzuki","year":"1990","journal-title":"Comput"},{"key":"ref161","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1515\/JPEM.2004.17.4.655","article-title":"Reversibility of thyrotroph hyperplasia after thyroxine replacement therapy in patients with juvenile primary hypothyroidism","volume":"17","author":"Bhansali","year":"2004","journal-title":"J Pediatr Endocrinol Metab"},{"key":"ref561","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1080\/07435800500371706","article-title":"Serum creatine kinase levels in overt and subclinical hypothyroidism","volume":"31","author":"Hekimsoy","year":"2005","journal-title":"Endocr Res"},{"key":"ref101","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1186\/1752-1947-7-149","article-title":"NS JE Primary hypothyroidism with growth failure and pituitary pseudotumor in a year - old female : a case report Case","volume":"13","author":"Larson","year":"2013","journal-title":"J Med Rep"},{"key":"ref551","first-page":"99","article-title":"child with pericardial effusion and cardiac tamponade due to previously unrecognized hypothyroidism","author":"Sanda","year":"2007","journal-title":"J Natl Med Assoc"},{"key":"ref91","first-page":"413","article-title":"Primary hypothyroidism in a year - old girl with a suprasellar pituitary mass : rapid regression after thyroid replacement therapy : case report","volume":"12","author":"Ashley","year":"2005","journal-title":"J Neurosurg"},{"key":"ref651","first-page":"271","article-title":"Ovarian cyst in juvenile hypothyroidism","author":"Singh","year":"2005","journal-title":"Arch Gynecol Obstet"},{"key":"ref61","article-title":"MR assessment of pituitary gland morphology in healthy volunteers : age - and gender - related differences","volume":"13","author":"Doraiswamy","year":"1992","journal-title":"Am J Neuroradiol"},{"key":"ref661","first-page":"895","article-title":"Ovarian cysts in young girls with hypothyroidism : follow - up and effect of treatment","volume":"19","author":"Sharma","year":"2006","journal-title":"PS J Pediatr Endocrinol Metab"},{"key":"ref511","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1515\/JPEM.2004.17.4.655","article-title":"Reversibility of thyrotroph hyperplasia after thyroxine replacement therapy in patients with juvenile primary hypothyroidism","volume":"17","author":"Bhansali","year":"2004","journal-title":"J Pediatr Endocrinol Metab"},{"key":"ref461","article-title":"pseudotumor with unusual presentation reversed shortly after the introduction of thyroxine replacement therapy","volume":"14","author":"Kocova","year":"2001","journal-title":"Pituitary J Pediatr Endocrinol Metab"},{"key":"ref241","first-page":"141","article-title":"case of hypothyroidism mimicking acute coronary syndrome Imaging","volume":"22","author":"Gunduz","year":"2006","journal-title":"Int J"},{"key":"ref451","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1186\/1752-1947-7-149","article-title":"NS JE Primary hypothyroidism with growth failure and pituitary pseudotumor in a year - old female : a case report Case","volume":"13","author":"Larson","year":"2013","journal-title":"J Med Rep"},{"key":"ref21","first-page":"39","article-title":"See Primary hypothyroidism mimicking a pituitary macroadenoma : regression after thyroid hormone replacement therapy","author":"Sung","year":"2009","journal-title":"Pediatr Radiol"},{"key":"ref271","first-page":"10","article-title":"Reversible hepatic dysfunction associated with rhabdomyolysis","author":"Akmal","year":"1990","journal-title":"Am J Nephrol"},{"key":"ref171","article-title":"de Chronic autoimmune thyroiditis in children and adolescents : at presentation and during long - term follow - up","volume":"33","author":"Bulvik","year":"2009","journal-title":"Vries Arch Dis Child"},{"key":"ref671","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1007\/s00247-008-0777-1","article-title":"LP Grumbach syndrome revisited imaging and clinical findings in pre - and postpubertal girls","author":"Browne","year":"2008","journal-title":"Pediatr Radiol"},{"key":"ref581","first-page":"668","article-title":"AN Hyperkeratosis as a clue to diagnosis in a patient with myopathy","volume":"16","author":"Cebeci","year":"2013","journal-title":"Ann Acad"},{"key":"ref81","doi-asserted-by":"crossref","first-page":"429","DOI":"10.4158\/EP12011.VV","article-title":"Visual vignette cell hyperplasia","volume":"18","author":"Lee","year":"2012","journal-title":"Endocr Pract"},{"key":"ref441","first-page":"413","article-title":"Primary hypothyroidism in a year - old girl with a suprasellar pituitary mass : rapid regression after thyroid replacement therapy : case report","volume":"12","author":"Ashley","year":"2005","journal-title":"J Neurosurg"},{"key":"ref321","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1007\/s00247-008-0777-1","article-title":"LP Grumbach syndrome revisited imaging and clinical findings in pre - and postpubertal girls","author":"Browne","year":"2008","journal-title":"Pediatr Radiol"},{"key":"ref141","first-page":"212","article-title":"ST Rapid progression of hypothyroidism - related pituitary hyperplasia Case report","author":"Lee","year":"2008","journal-title":"J Neurosurg"},{"key":"ref431","doi-asserted-by":"crossref","first-page":"429","DOI":"10.4158\/EP12011.VV","article-title":"Visual vignette cell hyperplasia","volume":"18","author":"Lee","year":"2012","journal-title":"Endocr Pract"},{"key":"ref201","first-page":"99","article-title":"child with pericardial effusion and cardiac tamponade due to previously unrecognized hypothyroidism","author":"Sanda","year":"2007","journal-title":"J Natl Med Assoc"},{"key":"ref71","first-page":"36","article-title":"of normal pituitary gland on MR imaging age and sex differentiation Assist","volume":"14","author":"Suzuki","year":"1990","journal-title":"Comput"},{"key":"ref691","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1111\/j.1525-1470.2005.00114.x","article-title":"Acquired ichthyosis and hypertrichosis due to autoimmune thyroiditis : therapeutic response to thyroxine replacement","volume":"22","author":"Brazzelli","year":"2005","journal-title":"Pediatr Dermatol"},{"key":"ref681","doi-asserted-by":"crossref","first-page":"652","DOI":"10.4158\/EP.13.6.652","article-title":"Precocious puberty and large multicystic ovaries in young girls with primary hypothyroidism","volume":"13","author":"Sanjeevaiah","year":"2007","journal-title":"Endocr Pract"},{"key":"ref301","first-page":"271","article-title":"Ovarian cyst in juvenile hypothyroidism","author":"Singh","year":"2005","journal-title":"Arch Gynecol Obstet"},{"key":"ref491","first-page":"212","article-title":"ST Rapid progression of hypothyroidism - related pituitary hyperplasia Case report","author":"Lee","year":"2008","journal-title":"J Neurosurg"},{"key":"ref401","first-page":"362","article-title":"DM the requisites Philadelphia","author":"Yousem","year":"2010","journal-title":"Neuroradiology"},{"key":"ref231","first-page":"668","article-title":"AN Hyperkeratosis as a clue to diagnosis in a patient with myopathy","volume":"16","author":"Cebeci","year":"2013","journal-title":"Ann Acad"},{"key":"ref111","article-title":"pseudotumor with unusual presentation reversed shortly after the introduction of thyroxine replacement therapy","volume":"14","author":"Kocova","year":"2001","journal-title":"Pituitary J Pediatr Endocrinol Metab"},{"key":"ref311","first-page":"895","article-title":"Ovarian cysts in young girls with hypothyroidism : follow - up and effect of treatment","volume":"19","author":"Sharma","year":"2006","journal-title":"PS J Pediatr Endocrinol Metab"},{"key":"ref131","first-page":"202","article-title":"MR imaging of pituitary hypertrophy due to juvenile primary hypothyroidism : a case report Imaging","volume":"15","author":"Kuroiwa","year":"1995","journal-title":"Clin"},{"key":"ref341","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1111\/j.1525-1470.2005.00114.x","article-title":"Acquired ichthyosis and hypertrichosis due to autoimmune thyroiditis : therapeutic response to thyroxine replacement","volume":"22","author":"Brazzelli","year":"2005","journal-title":"Pediatr Dermatol"},{"key":"ref121","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1007\/s12098-013-1221-6","article-title":"AR hypothyroidism presenting as pituitary hyperplasia","author":"Namburi","year":"2014","journal-title":"Indian J Pediatr"},{"key":"ref331","doi-asserted-by":"crossref","first-page":"652","DOI":"10.4158\/EP.13.6.652","article-title":"Precocious puberty and large multicystic ovaries in young girls with primary hypothyroidism","volume":"13","author":"Sanjeevaiah","year":"2007","journal-title":"Endocr Pract"},{"key":"ref371","first-page":"39","article-title":"See Primary hypothyroidism mimicking a pituitary macroadenoma : regression after thyroid hormone replacement therapy","author":"Sung","year":"2009","journal-title":"Pediatr Radiol"},{"key":"ref621","first-page":"10","article-title":"Reversible hepatic dysfunction associated with rhabdomyolysis","author":"Akmal","year":"1990","journal-title":"Am J Nephrol"},{"key":"ref361","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1159\/000028649","article-title":"AR Primary hypothyroidism mimicking a pituitary macroadenoma","volume":"28","author":"Ehirim","year":"1998","journal-title":"Pediatr Neurosurg"},{"key":"ref31","first-page":"61","article-title":"Primary hypothyroidism in a child mimicking a pituitary macroadenoma","volume":"63","author":"Hopper","year":"2005","journal-title":"Horm Res"},{"key":"ref481","first-page":"202","article-title":"MR imaging of pituitary hypertrophy due to juvenile primary hypothyroidism : a case report Imaging","volume":"15","author":"Kuroiwa","year":"1995","journal-title":"Clin"},{"key":"ref521","article-title":"de Chronic autoimmune thyroiditis in children and adolescents : at presentation and during long - term follow - up","volume":"33","author":"Bulvik","year":"2009","journal-title":"Vries Arch Dis Child"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1159\/000028649","article-title":"AR Primary hypothyroidism mimicking a pituitary macroadenoma","volume":"28","author":"Ehirim","year":"1998","journal-title":"Pediatr Neurosurg"},{"key":"ref281","first-page":"416","article-title":"Syndrome of precocious menstration and galactorrhea in juvenile hypothyroidism : an example of hormonal overlap in pituitary feedback","author":"van","year":"1960","journal-title":"J Pediatr"},{"key":"ref501","first-page":"877","article-title":"hyperplasia in children with short stature and primary hypothyroidism","author":"Aijing","year":"2010","journal-title":"Pituitary Indian Pediatr"},{"key":"ref181","first-page":"122","article-title":"Goitrous autoimmune thyroiditis in a pediatric population : a longitudinal study","author":"Gopalakrishnan","year":"2008","journal-title":"Pediatrics"},{"key":"ref51","first-page":"362","article-title":"DM the requisites Philadelphia","author":"Yousem","year":"2010","journal-title":"Neuroradiology"},{"key":"ref151","first-page":"877","article-title":"hyperplasia in children with short stature and primary hypothyroidism","author":"Aijing","year":"2010","journal-title":"Pituitary Indian Pediatr"}],"container-title":["Journal of Pediatric Endocrinology and Metabolism"],"original-title":[],"link":[{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2015-0157\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,22]],"date-time":"2021-04-22T01:39:15Z","timestamp":1619055555000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2015-0157\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,1,1]]},"references-count":62,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.1515\/jpem-2015-0157","relation":{},"ISSN":["2191-0251","0334-018X"],"issn-type":[{"value":"2191-0251","type":"electronic"},{"value":"0334-018X","type":"print"}],"subject":[],"published":{"date-parts":[[2016,1,1]]}}}