1. Department of Endocrinology and Rheumatology,
2. Department of Radiology,
3. Department of Hepatobiliary Surgery, 309 th Hospital of PLA, Beijing 100091 China;
4. Department of Oncology, Air Forces General hospital of PLA, Beijing 100142 China
Abstract:Objective To analyze the clinical characteristics and pathogenesis of the patients with pituitary stalk interruption(block) syndrome (PSIS), there by better comprehending this disease. Methods A new case of PSIS was reported, and a literature review was conducted of Chinese reports on PSIS retrieved in CHKD and WANFANG Medical database. Results Since 2004, 311 cases of PSIS were reported in 33 papers from 14 provinces and cities, including this case. PSIS had a male predominance (257 male, 54 female). 183 of 311 had an abnormal labor or cerebral anoxia history. Magnetic resonance imaging (MRI) showed pituitary stalk rupture in 239 cases and significant thin pituitary stalk in 62 cases. Multiple hormone deficits were observed in 190 patients and single growth hormone deficiency in 75 cases. The patients with pituitary stalk rupture have a predominance of multiple hormone deficits, and the patients with pituitary stalk necking have a predominance of growth hormone deficiencies (P<0.01). The major clinical manifestations in adolescent patients are growth retardation and secondary sexual characters missing or delay, and the babies with PSIS are characterized by repeated attack of hypoglycemia and convulsions. Generally, the treatment for PSIS patients is insufficient and delayed. Only 12 cases (3.86%) received the growth hormone treatment. Conclusion Abnormal labor or cerebral anoxia history is probably one of the most important causes of PSIS; MRI is an important method for diagnosis of PSIS. For suspected PSIS patients, cerebral MRI and endocrinological evaluation can be helpful for early diagnosis and treatment; strengthening protection for the perinatal fetus may be an important means for prevention and control of PSIS.
Fujisawa I,Kikuchi K,Nishimura K,et al. Transection of the pituitary Stalk: development of an ectopic posterior lobe assessed with MR imaging[J]. Radiology,1987,165(2):487-489.
Tauber M,Chevrei J,Diene G, et al.Long-term evolution of endocrin disorders and effeet of GH therapy in 35 patients with pituitary stalk interruption syndrome [J].Horm Res, 2005, 64(6): 266-273.
[2]
Fujisawa I,Kikuchi K,Nishimura K,et al. Transection of the pituitary Stalk: development of an ectopic posterior lobe assessed with MR imaging[J]. Radiology,1987,165(2):487-489.
[4]
Vimpani G V,Vimpani A F,Liclgard G P,et al.Prevalence of severe growth homone deficiency[J]. BrMed,1977,2:427-430.
Sheehan H L,Whitehead R. The neurohypophysis in post partum hypopituitarism [J]. Pathol Bacteriol,1963,85:145-169.
[4]
Vimpani G V,Vimpani A F,Liclgard G P,et al.Prevalence of severe growth homone deficiency[J]. BrMed,1977,2:427-430.
[6]
SloopK W, Walvoord E C, Showalter A D, et al.Molecular analysis of LHX3 and PROP-1 in pituitary homone deficiency patients with posterior pituitary ectopia[J].Clin Endocrinol Metab,2000,85:2701-2708.
[5]
Sheehan H L,Whitehead R. The neurohypophysis in post partum hypopituitarism [J]. Pathol Bacteriol,1963,85:145-169.
SloopK W, Walvoord E C, Showalter A D, et al.Molecular analysis of LHX3 and PROP-1 in pituitary homone deficiency patients with posterior pituitary ectopia[J].Clin Endocrinol Metab,2000,85:2701-2708.
[8]
Komreich I, Horev G, Lazar L,et al.MR. Findings in growth homone defreiency correlation with severity of hypopituitarism[J]. AJNR,1998,19:1495-1499.
[9]
Chen S, Leger J Garel C, et al. Growth homone deficiency patients with ectopic neurohyphysis anatomical variations and relationship between the visibility of the pituitary stalk asserted by maging and anterior pituitary function[J].Clin Endocrinol Metab,1999,80:128-132.
Vimpani G V, Vimpan A F, Lidgand G P, et al.Prevalence of severe growth homone deficiency[J]. BrMed,1977, 6084(2):427-430.
[8]
Komreich I, Horev G, Lazar L,et al.MR. Findings in growth homone defreiency correlation with severity of hypopituitarism[J]. AJNR,1998,19:1495-1499.
[9]
Chen S, Leger J Garel C, et al. Growth homone deficiency patients with ectopic neurohyphysis anatomical variations and relationship between the visibility of the pituitary stalk asserted by maging and anterior pituitary function[J].Clin Endocrinol Metab,1999,80:128-132.
[10]
Vimpani G V, Vimpan A F, Lidgand G P, et al.Prevalence of severe growth homone deficiency[J]. BrMed,1977, 6084(2):427-430.