Hypopituitarism masquerading as Prasad's syndrome: a case report

Area of Science:

• Pediatric Endocrinology
• Nutritional Deficiencies
• Genetic Syndromes

Background:

• Prasad's syndrome is defined by geophagia, growth retardation, hypogonadism, and zinc deficiency.
• This case highlights the importance of comprehensive evaluation in patients presenting with symptoms suggestive of Prasad's syndrome.

Observation:

• A 15-year-old male presented with severe growth retardation, pubertal delay, iron deficiency anemia, and zinc deficiency.
• Endocrine assessment revealed growth hormone deficiency and hypogonadotropic hypogonadism, with pituitary hypoplasia noted on MRI.
• Negative gliadin and endomysium antibodies ruled out celiac disease; thyroid function was normal.

Findings:

• The patient's clinical presentation was consistent with Prasad's syndrome.
• However, detailed endocrinological evaluation uncovered significant pituitary dysfunction, including growth hormone deficiency and hypogonadotropic hypogonadism.
• Pituitary hypoplasia was identified as a potential underlying cause for the observed hormonal deficiencies.

Implications:

• Endocrine evaluation, particularly for hypopituitarism, should be considered before a definitive diagnosis of Prasad's syndrome.
• Symptoms of hypogonadotropic hypogonadism and growth hormone deficiency can be obscured by the presentation of Prasad's syndrome.
• This case underscores the necessity of ruling out pituitary abnormalities in children with geophagia and growth failure.