A Case of Posttraumatic Hypopituitarism

Kanayama, Yoshiharu; Kubo, Kenji; Furukawa, Yôko; Morii, Hirotoshi; Wada, Masahisa; Nakai, Yoshikatsu; Irie, Minoru

doi:10.1507/endocrj1954.19.517

Endocrinol Japon

1972

DOI: 10.1507/endocrj1954.19.517

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A Case of Posttraumatic Hypopituitarism

Yoshiharu Kanayama

Kenji Kubo

Yôko Furukawa

et al.

Abstract: SynopsisA case of posttraumatic hypopituitarism was studied. A 46-years-old man suffered from adrenal crisis after he showed symptoms of hypopituitarism which was caused by the head injury of 26 years ago. Hyponatremia was prominent at the time of admission. Clinical and laboratory studies revealed hypothyroidism, hypofunction of adrenal gland and hypogonadism. Blood pituitary hormones-ACTH, GH, TSH and LH were determined by radioimmunoassay. Plasma ACTH levels were not detectable (below 10 pg/ml) even after m… Show more

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Cited by 4 publications

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“…1978;Kanamaya et al 1972;Klachko et al 1968;Me Cullagh & Schaffenburg 1953;Paxson & Brown 1976;Robertson 8c Kirkpatrick 1951;Winternitz & Dzur 1976). This re¬ port concerns a well documented case of posttraumatic panhypopituitarism in which a hypo¬ thalamic, rather than pituitary, origin has been established.…”

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Panhypopituitarism secondary to head trauma: evidence for a hypothalamic origin of the deficit

Jambart¹,

Turpin²,

Gennes³

1980

Acta Endocrinologica

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A complete endocrinological exploration was performed in a 23 year old male patient who presented clinical signs of an acquired panhypopituitarism which appeared two months after a severe head trauma, in order to determine whether the deficit lay in the hypothalamus or in the pituitary. TSH had normal basal levels, but presented a delayed rise after TRH administration. PRL rose normally after TRH administration, but presented a blunted response to both metoclopramide and insulin tolerance test. Cortisol rose significatively after lysine vasopresssin, but failed to rise during insulin hypoglycaemia. These results are consistent with a hypothalamic defect. Extensive endocrinological data are often lacking in the few similar cases reported in the literature. Prl and TSH were usually found to have normal basal levels while other pituitary hormones were profoundly lowered. This was interpretated as a pituitary defect with some intact areas of the anterior lobe. However, this may also suggest a hypothalamic defect which could have been assessed by more discriminative tests.Hypothalamo-pituitary deficits following head trauma have rarely been reported and endocrine exploration was generally inadequate in those cases (). This re¬ port concerns a well documented case of posttraumatic panhypopituitarism in which a hypo¬ thalamic, rather than pituitary, origin has been established. Case reportA 23 year old white male patient was referred to our hospital with typical clinical signs of panhypopituitarism that had appeared five years earlier, following a car accident. He suffered severe head trauma with three hours loss of consciousness, vertebral fractures, left conjunctival haemorrhage and multiple skin injuries.Past medical history was unremarkable; no neonatal anoxia, slight overweight during childhood, normal growth with a height of 169 cm attained at 18 years. The onset of puberty was at 14 years. Sexual hair was normal¬ ly distributed but scanty. Erections and ejaculations were present. History of meningoencephalitis or of head or neck external irradiation was lacking.Two months after the head trauma, secondary sex characteristics regressed completely with abolition of sexual activity. Meanwhile, the patient complained of pallor, physical and mental asthenia, but did not show cold intolerance and was not constipated. He had a ten kilograms weight-gain in the year following the accident, his weight on admission was 95 kg. On physical examination, the blood pressure was 120-80 mmHg and the pulse rate was 60/min. Pubic and axillary hair were absent but the testes measured 2.5 x 2 cm and were of normal consistency. The penis was normal-sized. No galactorrhoea nor gynaecomastia were found, but adipomastia with abdominotruncular obesity were noted. The skin was slightly infiltrated. Features suggesting increased intracranial pressure were absent (no headache, papilloedema, nor polyuria-polydypsia). The patient was tuberculine-positive. There was no arachnodactylia nor retinitis pigmentosa. The bone age was determined to be 17...

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mentioning

confidence: 99%

Panhypopituitarism secondary to head trauma: evidence for a hypothalamic origin of the deficit

Jambart¹,

Turpin²,

Gennes³

1980

Acta Endocrinologica

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Panhypopituitarism and anemia secondary to traumatic fracture of the sella turcica

Kanade

Ruiz

Tornyos

et al. 1978

J Endocrinol Invest

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A case of a 27 year old man who developed anemia after fracture of the sella turcica is reported. The diagnosis of anterior pituitary insufficiency was made by a combined provocative test with TRH, LHRH, and insulin. The anemia was characterized by a hypocellular bone marrow which appeared to be functioning only in the thoracic-lumbar vertebrae, an absence of measurable erythropoietic activity, and by the return to normal of the hematological findings after hormonal replacement therapy. This patient had the highly unusual combination of proven panhypopituitarism and significant anemia resulting from a distinct fracture of the sella turcica.

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Clinical studies of human growth hormone

Root

1976

Pharmacology & Therapeutics. Part C: Clinical Pharmacology

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A Case of Posttraumatic Hypopituitarism

Cited by 4 publications

References 10 publications

Panhypopituitarism secondary to head trauma: evidence for a hypothalamic origin of the deficit

Panhypopituitarism secondary to head trauma: evidence for a hypothalamic origin of the deficit

Panhypopituitarism and anemia secondary to traumatic fracture of the sella turcica

Clinical studies of human growth hormone

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