[A case report of idiopathic myxedema with secondary amenorrhoea and hyperprolactinemia: effect of thyroid hormone replacement on reduction of pituitary enlargement and restoration of fertility].

A 37-year old housewife was admitted to our department because of long-standing amenorrhoea and galactorrhoea. After several hormonal examinations, she was proved to be suffered from primary hypothyroidism with hyperprolactinemia. In addition, brain computed tomography (CT) showed the finding of enhanced pituitary enlargement, suggesting pituitary hypertrophy or pituitary adenoma. Based on some therapeutic experiences in similar cases in several reports, we have performed only thyroid hormone replacement and followed up the patient. Plasma thyroid stimulating hormone (TSH) and prolactin concentrations returned to normal range in a few months after starting thyroid hormone replacement. Furthermore, the finding of pituitary enlargement has completely disappeared on brain CT and come to pregnancy during the course. Thus, it seems that the finding of pituitary enlargement might be due to pituitary hypertrophy. Therefore, we think that thyroid hormone replacement should be a first choice therapy preceding the pituitary surgery or bromocriptine therapy in such a case.