title: Hypopituitarism in a patient with transsphenoidal cephalocele: longitudinal changes in endocrinological abnormalities.
abstract: We report a 21-year-old man with severe fatigue due to hypopituitarism. At the age of 6 years, he was diagnosed with short stature due to a GH deficiency accompanied by a sphenoid cystic lesion. Laboratory findings and provocative tests for pituitary hormone function revealed ACTH, LH, FSH, TSH, and GH deficiency. Computed tomography and magnetic resonance imaging revealed transsphenoidal cephalocele due to a defect in the floor of the sella turcica. At 6 years, he only had severe GH deficiency and poor response of LH to LHRH. Hypothalamic-pituitary dysfunction and pituitary herniation have progressed subsequently; we observed a longitudinal progression of hypothalamic-pituitary dysfunction caused by transsphenoidal cephalocele. This dysfunction requires the selection of a treatment that will not aggravate the condition further.
authors.affiliation: Department of Internal Medicine (I), Osaka Medical College, Takatsuki, Japan. in1120@poh.osaka-med.ac.jp
authors.forename: Keiji
authors.initials: K
authors.lastname: Tanimoto
authors.forename: Saori
authors.initials: S
authors.lastname: Onda
authors.forename: Hideaki
authors.initials: H
authors.lastname: Sawaki
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Hiraiwa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sano
authors.forename: Mineki
authors.initials: M
authors.lastname: Ohnishi
authors.forename: Jungo
authors.initials: J
authors.lastname: Terasaki
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Hanafusa
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000172:deficiency; D015897:Comorbidity; D004677:Encephalocele / Q000453:epidemiology* / Q000378:metabolism / Q000503:physiopathology*; D005640:Follicle Stimulating Hormone / Q000172:deficiency; D013006:Growth Hormone / Q000172:deficiency; D006801:Humans; D007018:Hypopituitarism / Q000453:epidemiology* / Q000378:metabolism / Q000503:physiopathology*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008137:Longitudinal Studies; D007986:Luteinizing Hormone / Q000172:deficiency; D008297:Male; D010907:Pituitary Hormones / Q000172:deficiency*; D013972:Thyrotropin / Q000172:deficiency; D055815:Young Adult
chemical_list: D010907:Pituitary Hormones; D000324:Adrenocorticotropic Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D013972:Thyrotropin; D013006:Growth Hormone