Title:One Case of Pituitary Stalk Interruption Syndrome Associated with Liver
Cirrhosis
Volume: 23
Issue: 9
Author(s): Huan He and Dong Mei Li*
Affiliation:
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
Keywords:
Pituitary stalk interruption syndrome, hormone deficiencies, nonalcoholic fatty liver disease, liver cirrhosis, Growth hormone, PSIS.
Abstract:
Introduction: Pituitary stalk interruption syndrome (PSIS) is featured by hypopituitarism and
a classic triad of absence or slender pituitary stalk, absence or ectopic posterior lobe, and hypoplasia of
the anterior lobe. Hypopituitarism, which induces hormone deficiencies, is associated with non-alcoholic
fatty liver disease (NAFLD) and liver cirrhosis.
Case Presentation: A 29-year-old male patient was presented with intermittent nosebleeds and underdeveloped
secondary sexual characteristics. Laboratory examination revealed low gonadal hormone,
thyroxine, and cortisol levels. Magnetic resonance imaging revealed an interrupted pituitary stalk, ectopic
posterior pituitary, and hypoplastic anterior pituitary. PSIS was confirmed. Liver cirrhosis was
supported by bilirubin metabolism disorder, abnormal coagulation, the varicose vein of the esophagus
and fundus of the stomach, hypersplenism, and signs on a computer tomography scan. He received
glucocorticoid, levothyroxine, androgen, and human chorionic gonadotropin supplements, and growth
hormone was not given because of poverty. Five months later, the patient developed Cushing-like
symptoms and further deterioration of liver function.
Conclusion: PSIS can cause liver impairment and even cirrhosis, which may be associated with multiple
hormone deficiencies. A case of PSIS with cirrhosis as the initial symptom and progression of cirrhosis
in the absence of growth hormone (GH) therapy suggests that GH therapy may be important in
PSIS-related cirrhosis.
