A CASE OF SCHMIDT SYNDROME ACCOMPANIED BY A PITUITARY-ADENOMA

Schmidt syndrome consists of adrenal insufficiency and Hashimoto's thy roiditis, which are probably caused by an autoimmune process. We encou ntered a patient who manifested severe generalized fatigue due to Schm idt syndrome recurrently. The endocrinological examination tests on th e patient showed that the increase in thyroid stimulating hormone (TSH ) and ACTH concentrations were not remarkable, despite hypo-function o f the peripheral glands. Subsequent cranial magnetic resonance imaging (MRI) exhibited the existence of a pituitary tumor. The pathological findings on the resected tumor and endocrinological stimulation tests proved that the tumor was a FSH-producing adenoma. Although involvemen t of the pituitary region in Schmidt syndrome on rare occasions presen ts as hypophysitis, no pituitary adenoma has previously been reported in association with this syndrome. We present a patient with Schmidt s yndrome and an accompanying FSH-producing pituitary adenoma. The coexi stence of these disorders suggests that the functioning pituitary tumo r might be considered as a pituitary lesion in Schmidt syndrome.