Data Sheet 2_Case Report: A patient with an empty sella accompanied by rare thyrotoxicosis.docx

Empty sella (ES) involves herniation of the pituitary fossa, leading to pituitary flattening. While typically associated with central hypothyroidism, its co-occurrence with hyperthyroidism is rarely reported and often overlooked. We report a rare case of hyperthyroidism in a patient with ES. The patient was diagnosed with ES combined with Graves’ disease (GD) and Hashimoto’s thyroiditis (HT). Her pituitary gland appeared flattened with a depressed upper edge. The gland height was approximately 2.3 mm. Abnormal thyroid function in this case may result from the combined effects of all three conditions. A literature search on PubMed revealed a possible association between ES and autoimmune thyroid disease; however, only seven relevant studies were identified, and no standardized diagnostic or treatment protocols exist. Hyperthyroidism may mask the diagnosis of ES. In patients whose thyroid function does not normalize with conventional oral antithyroid medication, the possibility of ES should be considered. When ES is associated with primary hyperthyroidism, antithyroid drug dosages should be lower than conventional doses. Thyroid function should be monitored more frequently, and medication dosages should be adjusted promptly.

空泡蝶鞍综合征（Empty sella，ES）指垂体窝发生疝出，进而导致垂体扁平。该病通常与中枢性甲状腺功能减退症相关，但与甲状腺功能亢进症（甲亢）合并出现的情况鲜有报道且常被忽视。本文报告1例ES合并甲状腺功能亢进症的罕见病例：该患者同时被诊断为ES、格雷夫斯病（Graves’ disease，GD）与桥本甲状腺炎（Hashimoto’s thyroiditis，HT），影像学检查显示其垂体扁平且上缘凹陷，腺体高度约为2.3 mm。本例患者的甲状腺功能异常可能是三种病症共同作用的结果。通过PubMed检索文献发现，ES与自身免疫性甲状腺疾病可能存在关联，但目前仅检索到7项相关研究，且尚无标准化诊疗方案。甲状腺功能亢进症可能会掩盖ES的诊断：对于经常规口服抗甲状腺药物治疗后甲状腺功能未恢复正常的患者，应考虑ES的可能性。当ES合并原发性甲状腺功能亢进症时，抗甲状腺药物的剂量应低于常规剂量，且需更频繁地监测甲状腺功能，及时调整用药剂量。