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The pituitary stalk transection syndrome: multifaceted presentation in adulthood
Adriana Gabriela Ioachimescu1, Amir H Hamrahian, Mariam Stevens
1Department of Medicine and Neurological Surgery, Emory University School of Medicine, 1365 B Clifton Rd NE, Atlanta, GA 30322, USA. aioachi@emory.edu
Pituitary
|August 10, 2011
Summary
Pituitary stalk transection syndrome, identified by MRI, presents varied hormonal deficits throughout life. Adult endocrinologists must consider this condition for patients with unexplained pituitary issues.
Area of Science:
- Endocrinology
- Radiology
- Pediatric Endocrinology
Background:
- Pituitary stalk transection syndrome (PSTS) is often diagnosed in childhood but its adult prevalence and natural history remain unclear.
- Magnetic Resonance Imaging (MRI) has been crucial in characterizing PSTS, revealing specific anatomical abnormalities.
Observation:
- This study details four adult cases of PSTS, highlighting its diverse clinical manifestations.
- All patients exhibited characteristic MRI findings: a small anterior pituitary, absent or diminutive infundibulum, and ectopic posterior pituitary.
- Hormonal deficiencies varied in onset and severity, with adrenal insufficiency, growth hormone deficiency, hypothyroidism, and hypogonadism observed across different ages.
Findings:
- PSTS can present with pleiotropic manifestations and variable hormonal deficits, including adrenal insufficiency, growth hormone deficiency, hypothyroidism, and hypogonadism.
- The syndrome's onset can range from childhood to the second decade of life, with deficiencies potentially emerging later.
- Characteristic MRI findings are key to diagnosing PSTS.
Implications:
- PSTS should be considered in adults with previously diagnosed idiopathic growth hormone deficiency or multiple pituitary hormone deficiencies.
- MRI findings suggestive of PSTS warrant a comprehensive hormonal evaluation.
- Long-term endocrinological follow-up is essential for adult patients with PSTS due to the potential for new hormone deficiencies to develop over time.
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