Somatostatin receptor ligands induce TSH deficiency in thyrotropin-secreting pituitary adenoma

in European Journal of Endocrinology
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  • 1 Centre de Référence des Maladies Rares de la Thyroïde et des Récepteurs Hormonaux TRH, Centre de Référence des Maladies Rares de l’Hypophyse HYPO, Service d’Endocrinologie, Diabétologie et Nutrition, CHU d’Angers, Angers Cedex, France
  • 2 Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Service d’Endocrinologie et des Maladies de la Reproduction, Centre de Référence des Maladies Rares de l’Hypophyse HYPO, Le Kremlin-Bicêtre, France
  • 3 UMR S-1185, Fac Med Paris-Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France
  • 4 Service d’Endocrinologie Diabétologie Nutrition, CHU de BREST, BREST Cedex, France
  • 5 Assistance Publique-Hôpitaux de Marseille (AP-HM), Service d’Endocrinologie, Hôpital de la Conception, Centre de Référence des Maladies Rares de l’Hypophyse HYPO, Institut National de la Santé et de la Recherche Médicale (INSERM), Marseille, France
  • 6 Service d’Endocrinologie, Diabétologie et Nutrition, Hôpital Haut Lévêque, CHU Bordeaux, Pessac, France
  • 7 INSERM, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, Bordeaux, France
  • 8 Université de Bordeaux, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, Bordeaux, France
  • 9 Service d’Endocrinologie et Nutrition, CHU Ambroise-Paré, AP-HP, Boulogne-Billancourt, France
  • 10 Inserm U1173, Université Versailles-Saint-Quentin, Montigny-Le-Bretonneux, France
  • 11 Service d’Endocrinologie et Métabolisme, CHU Lille, Lille, France
  • 12 UMR 1190 Translational Research in Diabetes INSERM, Lille, France
  • 13 Université de Lyon, Lyon1, Lyon, France
  • 14 Inserm U1052, CNRS UMR5286, Cancer Research Center of Lyon, Lyon, France
  • 15 Fédération d’Endocrinologie, Centre de Référence des Maladies Rares de l’Hypophyse HYPO, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron Cedex, France
  • 16 Centre de Référence des Maladies rares de la Thyroïde et des Récepteurs Hormonaux, Institut MITOVASC, Université d’Angers, Angers, France
  • 17 Centre de Référence des Maladies Rares de la Thyroïde et des Récepteurs Hormonaux TRH, Centre de Référence des Maladies Rares de l’Hypophyse HYPO Service d’Endocrinologie, Diabétologie et Nutrition, CHU d’Angers, Institut MITOVASC, Université d’Angers, Angers, France
  • 18 Centre de Référence des Maladies Rares de la Thyroïde et des Récepteurs Hormonaux TRH Centre de Référence des Maladies Rares de l’Hypophyse HYPO Service d’Endocrinologie, Diabétologie et Nutrition, CHU d’Angers, Institut MITOVASC, Université d’Angers, Angers, France

Correspondence should be addressed to F Illouz; Email: frillouz@chu-angers.fr
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Objective

Somatostatin receptor ligands (SRL) are useful to control central hyperthyroidism in patients with thyrotropin-secreting pituitary adenoma (TSH pituitary adenoma). The aim of this study was to describe the frequency of thyrotropin deficiency (TSH deficiency) in patients with TSH pituitary adenoma treated by SRL.

Design

Retrospective study.

Methods

Patients with central hyperthyroidism due to TSH pituitary adenoma treated by short or long-acting SRL were retrospectively included. TSH deficiency was defined by a low FT4 associated with non-elevated TSH concentrations during SRL therapy. We analysed the frequency of TSH deficiency and the characteristics of patients with or without TSH deficiency.

Results

Forty-six patients were included. SRL were used as the first-line therapy in 21 of 46 patients (46%). Central hyperthyroidism was controlled in 36 of 46 patients (78%). TSH deficiency appeared in 7 of 46 patients (15%) after a median time of 4 weeks (4–7) and for a median duration of 3 months (2.5–3). The TSH deficiency occurred after one to three injections of long-acting SRL used as first-line therapy in 6/7 cases. There were no differences in terms of clinical and hormonal features, size of adenomas or doses of SRL between patients with or without TSH deficiency.

Conclusions

SRL can induce TSH deficiency in patients with central hyperthyroidism due to TSH pituitary adenoma. Thyrotropic function should be assessed before the first three injections of SRL in order to track TSH deficiency and reduce the frequency of injections when control of thyrotoxicosis rather than tumour reduction is the aim of the treatment.

 

     European Society of Endocrinology

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  • 1

    Asa SL, Casar-Borota O, Chanson P, Delgrange E, Earls P, Ezzat S, Grossman A, Ikeda H, Inoshita N & Karavitaki N et al. From pituitary adenoma to pituitary neuroendocrine tumor (PitNET): an International Pituitary Pathology Club proposa. Endocrine-Related Cancer 2017 24 C5C8. (https://doi.org/10.1530/ERC-17-0004)

    • Search Google Scholar
    • Export Citation
  • 2

    Amlashi FG & Tritos NA Thyrotropin-secreting pituitary adenomas: epidemiology, diagnosis, and management. Endocrine 2016 52 427440. (https://doi.org/10.1007/s12020-016-0863-3)

    • Search Google Scholar
    • Export Citation
  • 3

    Azzalin A, Appin CL, Schniederjan MJ, Constantin T, Ritchie JC, Veledar E, Oyesiku NM & Ioachimescu AG Comprehensive evaluation of thyrotropinomas: single-center 20-year experience. Pituitary 2016 19 183193. (https://doi.org/10.1007/s11102-015-0697-7)

    • Search Google Scholar
    • Export Citation
  • 4

    Onnestam L, Berinder K, Burman P, Dahlqvist P, Engstrom BE, Wahlberg J & Nystrom HF National incidence and prevalence of TSH-secreting pituitary adenomas in Sweden. Journal of Clinical Endocrinology and Metabolism 2013 98 626635. (https://doi.org/10.1210/jc.2012-3362)

    • Search Google Scholar
    • Export Citation
  • 5

    Melmed S Pituitary-tumor endocrinopathies. New England Journal of Medicine 2020 382 937950. (https://doi.org/10.1056/NEJMra1810772)

  • 6

    Beck-Peccoz P, Giavoli C & Lania A A 2019 update on TSH-secreting pituitary adenomas. Journal of Endocrinological Investigation 2019 42 14011406. (https://doi.org/10.1007/s40618-019-01066-x)

    • Search Google Scholar
    • Export Citation
  • 7

    Cossu G, Daniel RT, Pierzchala K, Berhouma M, Pitteloud N, Lamine F, Colao A & Messerer M Thyrotropin-secreting pituitary adenomas: a systematic review and meta-analysis of postoperative outcomes and management. Pituitary 2019 22 7988. (https://doi.org/10.1007/s11102-018-0921-3)

    • Search Google Scholar
    • Export Citation
  • 8

    Beck-Peccoz P, Lania A, Beckers A, Chatterjee K & Wemeau JL 2013 European Thyroid Association guidelines for the diagnosis and treatment of thyrotropin-secreting pituitary tumors. European Thyroid Journal 2013 2 7682. (https://doi.org/10.1159/000351007)

    • Search Google Scholar
    • Export Citation
  • 9

    Bertherat J, Brue T, Enjalbert A, Gunz G, Rasolonjanahary R, Warnet A, Jaquet P & Epelbaum J Somatostatin receptors on thyrotropin-secreting pituitary adenomas: comparison with the inhibitory effects of octreotide upon in vivo and in vitro hormonal secretions. Journal of Clinical Endocrinology and Metabolism 1992 75 540546. (https://doi.org/10.1210/jcem.75.2.1353505)

    • Search Google Scholar
    • Export Citation
  • 10

    Malchiodi E, Profka E, Ferrante E, Sala E, Verrua E, Campi I, Lania AG, Arosio M, Locatelli M & Mortini P et al. Thyrotropin-secreting pituitary adenomas: outcome of pituitary surgery and irradiation. Journal of Clinical Endocrinology and Metabolism 2014 99 20692076. (https://doi.org/10.1210/jc.2013-4376)

    • Search Google Scholar
    • Export Citation
  • 11

    Yamada S, Fukuhara N, Horiguchi K, Yamaguchi-Okada M, Nishioka H, Takeshita A, Takeuchi Y, Ito J & Inoshita N Clinicopathological characteristics and therapeutic outcomes in thyrotropin-secreting pituitary adenomas: a single-center study of 90 cases. Journal of Neurosurgery 2014 121 14621473. (https://doi.org/10.3171/2014.7.JNS1471)

    • Search Google Scholar
    • Export Citation
  • 12

    Beck-Peccoz P & Persani L Medical management of thyrotropin-secreting pituitary adenomas. Pituitary 2002 5 8388. (https://doi.org/10.1023/a:1022360414062)

    • Search Google Scholar
    • Export Citation
  • 13

    Chanson P, Weintraub BD & Harris AG Octreotide therapy for thyroid-stimulating hormone-secreting pituitary adenomas. A follow-up of 52 patients. Annals of Internal Medicine 1993 119 236240. (https://doi.org/10.7326/0003-4819-119-3-199308010-00010)

    • Search Google Scholar
    • Export Citation
  • 14

    Gatto F, Grasso LF, Nazzari E, Cuny T, Anania P, Di Somma C, Colao A, Zona G, Weryha G & Pivonello R et al. Clinical outcome and evidence of high rate post-surgical anterior hypopituitarism in a cohort of TSH-secreting adenoma patients: might somatostatin analogs have a role as first-line therapy? Pituitary 2015 18 583591. (https://doi.org/10.1007/s11102-014-0611-8)

    • Search Google Scholar
    • Export Citation
  • 15

    Kuhn JM, Arlot S, Lefebvre H, Caron P, Cortet-Rudelli C, Archambaud F, Chanson P, Tabarin A, Goth MI & Blumberg J et al. Evaluation of the treatment of thyrotropin-secreting pituitary adenomas with a slow release formulation of the somatostatin analog lanreotide. Journal of Clinical Endocrinology and Metabolism 2000 85 14871491. (https://doi.org/10.1210/jcem.85.4.6548)

    • Search Google Scholar
    • Export Citation
  • 16

    Socin HV, Chanson P, Delemer B, Tabarin A, Rohmer V, Mockel J, Stevenaert A & Beckers A The changing spectrum of TSH-secreting pituitary adenomas: diagnosis and management in 43 patients. European Journal of Endocrinology 2003 148 433442. (https://doi.org/10.1530/eje.0.1480433)

    • Search Google Scholar
    • Export Citation
  • 17

    Gatto F, Barbieri F, Castelletti L, Arvigo M, Pattarozzi A, Annunziata F, Saveanu A, Minuto F, Castellan L & Zona G et al. In vivo and in vitro response to octreotide LAR in a TSH-secreting adenoma: characterization of somatostatin receptor expression and role of subtype 5. Pituitary 2011 14 141147. (https://doi.org/10.1007/s11102-010-0271-2)

    • Search Google Scholar
    • Export Citation
  • 18

    Horiguchi K, Yamada M, Umezawa R, Satoh T, Hashimoto K, Tosaka M, Yamada S & Mori M Somatostatin receptor subtypes mRNA in TSH-secreting pituitary adenomas: a case showing a dramatic reduction in tumor size during short octreotide treatment. Endocrine Journal 2007 54 371378. (https://doi.org/10.1507/endocrj.k06-177)

    • Search Google Scholar
    • Export Citation
  • 19

    Yoshihara A, Isozaki O, Hizuka N, Nozoe Y, Harada C, Ono M, Kawamata T, Kubo O, Hori T & Takano K Expression of type 5 somatostatin receptor in TSH-secreting pituitary adenomas: a possible marker for predicting long-term response to octreotide therapy. Endocrine Journal 2007 54 133138. (https://doi.org/10.1507/endocrj.k06-133)

    • Search Google Scholar
    • Export Citation
  • 20

    Rimareix F, Grunenwald S, Vezzosi D, Riviere LD, Bennet A & Caron P Primary medical treatment of thyrotropin-secreting pituitary adenomas by first-generation somatostatin analogs: a case study of seven patients. Thyroid 2015 25 877882. (https://doi.org/10.1089/thy.2015.0041)

    • Search Google Scholar
    • Export Citation
  • 21

    van Varsseveld NC, Bisschop PH, Biermasz NR, Pereira AM, Fliers E & Drent ML A long-term follow-up study of eighteen patients with thyrotrophin-secreting pituitary adenomas. Clinical Endocrinology 2014 80 395402. (https://doi.org/10.1111/cen.12290)

    • Search Google Scholar
    • Export Citation
  • 22

    Rabbiosi S, Peroni E, Tronconi GM, Chiumello G, Losa M & Weber G Asymptomatic thyrotropin-secreting pituitary macroadenoma in a 13-year-old girl: successful first-line treatment with somatostatin analogs. Thyroid 2012 22 10761079. (https://doi.org/10.1089/thy.2012.0077)

    • Search Google Scholar
    • Export Citation
  • 23

    Mannavola D, Persani L, Vannucchi G, Zanardelli M, Fugazzola L, Verga U, Facchetti M & Beck-Peccoz P Different responses to chronic somatostatin analoganalogs in patients with central hyperthyroidism. Clinical Endocrinology 2005 62 176181. (https://doi.org/10.1111/j.1365-2265.2004.02192.x)

    • Search Google Scholar
    • Export Citation
  • 24

    Kirkman MA, Jaunmuktane Z, Brandner S, Khan AA, Powell M & Baldeweg SE Active and silent thyroid-stimulating hormone-expressing pituitary adenomas: presenting symptoms, treatment, outcomes, and recurrence. World Neurosurgery 2014 82 12241231. (https://doi.org/10.1016/j.wneu.2014.03.031)

    • Search Google Scholar
    • Export Citation
  • 25

    Capraru OM, Gaillard C, Vasiljevic A, Lasolle H, Borson-Chazot F, Raverot V, Jouanneau E, Trouillas J & Raverot G Diagnosis, pathology, and management of TSH-secreting pituitary tumors. A single-center retrospective study of 20 patients from 1981 to 2014. Annales d’Endocrinologie 2019 80 216224. (https://doi.org/10.1016/j.ando.2019.06.006)

    • Search Google Scholar
    • Export Citation
  • 26

    Persani L, Brabant G, Dattani M, Bonomi M, Feldt-Rasmussen U, Fliers E, Gruters A, Maiter D, Schoenmakers N & van Trotsenburg ASP 2018 European Thyroid Association (ETA) guidelines on the diagnosis and management of central hypothyroidism. European Thyroid Journal 2018 7 225237. (https://doi.org/10.1159/000491388)

    • Search Google Scholar
    • Export Citation
  • 27

    Beck-Peccoz P, Persani L, Mannavola D & Campi I Pituitary tumors: TSH-secreting adenomas. Best Practice and Research: Clinical Endocrinology and Metabolism 2009 23 597606. (https://doi.org/10.1016/j.beem.2009.05.006)

    • Search Google Scholar
    • Export Citation
  • 28

    Rotermund R, Riedel N, Burkhardt T, Matschke J, Schmidt NO, Aberle J & Flitsch J Surgical treatment and outcome of TSH-producing pituitary adenomas. Acta Neurochirurgica 2017 159 12191226. (https://doi.org/10.1007/s00701-017-3105-4)

    • Search Google Scholar
    • Export Citation
  • 29

    Fliers E, van Furth WR & Bisschop PH Cure of a thyrotrophin (TSH)-secreting pituitary adenoma by medical therapy. Clinical Endocrinology 2012 77 788790. (https://doi.org/10.1111/j.1365-2265.2012.04405.x)

    • Search Google Scholar
    • Export Citation
  • 30

    Samuels MH, Henry P & Ridgway EC Effects of dopamne ans somatostatin on pulsatile pituitary glycoprotein secretion. Journal of Clinical Endocrinology and Metabolism 1992 74 217222. (https://doi.org/10.1210/jcem.74.1.1345783)

    • Search Google Scholar
    • Export Citation
  • 31

    Colao A, Merola B, Ferone D, Marzullo P, Cerbone G, Longobardi S, Di Somma C & Lombardi G Acute and chronic effects of octreotide on thyroid axis in growth hormone-secreting and clinically non-functioning pituitary adenomas. European Journal of Endocrinology 1995 133 189194. (https://doi.org/10.1530/eje.0.1330189)

    • Search Google Scholar
    • Export Citation
  • 32

    Freda PU Somatostatin analogs in acromegaly. Journal of Clinical Endocrinology and Metabolism 2002 87 30133018. (https://doi.org/10.1210/jcem.87.7.8665)

    • Search Google Scholar
    • Export Citation
  • 33

    Enjalbert A, Rasolonjanahary R, Moyse E, Kordon C & Epelbaum J Guanine nucleotide sensitivity of [125I]-iodo NTyr somatostatin binding in rat adenohypophysis and cerebral cortex. Endocrinology 1983 113 822824. (https://doi.org/10.1210/endo-113-2-822)

    • Search Google Scholar
    • Export Citation
  • 34

    Epelbaum J, Enjalbert A, Krantic S, Musset F, Bertrand P, Rasolonjanahary R, Shu C & Kordon C Somatostatin receptors on pituitary somatotrophs, thyrotrophs, and lactotrophs: pharmacological evidence for loose coupling to adenylate cyclase. Endocrinology 1987 121 21772185. (https://doi.org/10.1210/endo-121-6-2177)

    • Search Google Scholar
    • Export Citation
  • 35

    Filopanti M, Ballare E, Lania AG, Bondioni S, Verga U, Locatelli M, Zavanone LM, Losa M, Gelmini S & Peri A et al. Loss of heterozygosity at the SS receptor type 5 locus in human GH- and TSH-secreting pituitary adenomas. Journal of Endocrinological Investigation 2004 27 937942. (https://doi.org/10.1007/BF03347536)

    • Search Google Scholar
    • Export Citation