Hypothalamic Hypopituitarism Caused by Pituitary Stalk Dysgenesis.
- Author:
Seong Ju LEE
1
;
Hye Jin YOON
;
A Reum CHO
;
Yoo Jin UM
;
Keun Young PARK
;
Dong Mee LIM
;
Byung Joon KIM
Author Information
1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
- Publication Type:Case Report
- Keywords:
Delayed puberty;
Hypothalamic hypopituitarism;
Pituitary stalk dysgenesis
- MeSH:
Adult;
Follicle Stimulating Hormone;
Hair;
Humans;
Hypopituitarism;
Hypothalamus;
Luteinizing Hormone;
Magnetic Resonance Imaging;
Pituitary Function Tests;
Pituitary Gland;
Pituitary Gland, Anterior;
Puberty, Delayed;
Testosterone;
Thyrotropin;
Thyrotropin-Releasing Hormone
- From:Korean Journal of Medicine
2013;85(4):420-424
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Functional defects of the pituitary gland are a rare cause of pubertal delay. The pituitary stalk is an important structure that connects the hypothalamus and pituitary gland. A defect in fusion of the pituitary stalk and anterior pituitary gland will block the function of the anterior pituitary gland. A 28-year-old man was referred to our clinic with poorly developed secondary sexual characteristics. He had undeveloped facial, axillary, and pubic hair and was Tanner stage I. Laboratory tests gave random serum testosterone < 0.025 ng/mL, luteinizing hormone (LH) < 0.1 mIU/mL, follicle-stimulating hormone (FSH) 0.626 mIU/mL, thyroid-stimulating hormone (TSH) 6.85 microIU/mL, and fT4 6.96 pmol/L. Sella magnetic resonance imaging (MRI) showed no pituitary stalk enhancement. The response in the combined pituitary function test revealed multiple hormonal defects, while the TSH response to thyrotropin-releasing hormone (TRH) was exaggerated and delayed. Therefore, we concluded that pituitary stalk dysgenesis had led to hypothalamic-type panhypopituitarism.
