Primary Empty Sella with Partial Hypopituitarism and Autoimmune Thyroiditis

Abstract

Laboratory Work-up : LH and FSH were low with estradio l at pre-puber ta l leve l , suggest ing hypogonadotropic hypogonadism. Prolactin was slightly elevated. Twenty four-hour urinary free cortisol and 8AM serum cortisol were low with low normal plasma ACTH, indicating secondary adrenal insufficiency. TSH was elevated with depressed FT4 and elevated antithyroglobulin, suggesting autoimmune thyroiditis. The following tests were normal: growth hormone, FBS and 2-hour OGTT. Patient had delayed bone age by the Greulich-Pyle method. Bone densitometry revealed osteoporosis. Patient had 46XX karyotype. Pelvic ultrasound revealed infantile uterus. Sellar MRI showed empty sella.