Pituitary stalk interruption syndrome: a case report and review of the literature
Article Category: Clinical report
Published Online: Jan 31, 2017
Page range: 237 - 243
DOI: https://doi.org/10.5372/1905-7415.0902.393
Keywords
© 2017 Yan Zhang, Changbin Quan, Weimin Li, Liying Chen, Xiaoyan Song, Jianbin Xu, Guangqing Zhu
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Background
Pituitary stalk interruption syndrome (PSIS) is characterized by a thin or interrupted pituitary stalk, impairing delivery of hypothalamic hormones to the pituitary, and anterior pituitary dysplasia.
Objectives
To summarize the manifestations and treatment of PSIS.
Methods
We performed a meta-analysis of PSIS research published between January 1, 2004 and December 31, 2013. Chinese databases were searched using the terms “pituitary stalk interruption syndrome”, “PSIS”, and “vertebral handle interrupts syndrome”; and results limited to clinical studies. Age of onset and diagnosis, sex, symptoms at presentation, main clinical signs, magnetic resonance imaging (MRI), laboratory results, and other data were extracted from qualifying studies.
Results
We included 311 cases from 33 papers in the meta-analysis. The male:female ratio was 257:54, and 183 of the 311 patients had a history of abnormal birth or cerebral hypoxia. MRI showed 239 cases of missing and 62 cases of tapered pituitary stalk. Multiple pituitary hormone deficiency was identified in 190 cases, and single growth hormone deficiency in 75. There were significant associations between missing pituitary stalk and multiple pituitary hormone deficiency, and pituitary stalk tapering and single hormone deficiency (
Conclusions
Abnormal delivery and cerebral hypoxia may be important causes of PSIS, and MRI is valuable for its diagnosis. Measuring the levels of pituitary hormones is necessary for timely diagnosis and treatment.