Abstract
To the Editor: I was puzzled by the discussion of the case report by Ahmed IM et al.1 Clinical presentation and biochemical tests in 1997 were fully consistent with a diagnosis of primary hypothyroidism (high thyroid stimulating hormone and low free thyroxine serum levels, hyponatremia, tiredness, lethargy). Cortisol level was normal, and thyroxine replacement therapy successfully restored thyroid function. Only 7 years later (clinical conditions are not described) were hypopituitarism and a pituitary macroadenoma seen. In conclusion, although the authors' statement about underdiagnosis of hypopituitarism in older people can be shared, their suggestion that, in this case, early diagnosis of hypopituitarism was missed is not justified. Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the author and has determined that the author has no financial or any other kind of personal conflicts with this letter. Author Contributions: The author is the sole contributor to this letter. Sponsor's Role: None.
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