Post-traumatic pituitary stalk transection syndrome (PSTS) expeditiously manifested after a fall from a height combined with acute traumatic spinal cord injury: a rare case report with review of literature
Post-traumatic pituitary stalk transection syndrome (PSTS) is an extremely rare cause of combined pituitary hormone deficiency (CPHD), affecting approximately 9 per 100,000 cases of traumatic brain injury. In contrast, pituitary stalk interruption syndrome (PSIS) is also a rare cause of CPHD. Import...
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The Japan Endocrine Society
2024-08-01
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| Series: | Endocrine Journal |
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| Online Access: | https://www.jstage.jst.go.jp/article/endocrj/71/8/71_EJ24-0091/_html/-char/en |
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| author | Yohei Ishiki Atsuko Tamaki Ken-ichiro Honma Ken Yonaha Takamitsu Yabiku Taiki Teruya Moriyuki Uehara Yoshiro Nakayama Rei Chinen Tsugumi Uema Sawako Nakachi Shiki Okamoto Hiroaki Masuzaki |
| author_facet | Yohei Ishiki Atsuko Tamaki Ken-ichiro Honma Ken Yonaha Takamitsu Yabiku Taiki Teruya Moriyuki Uehara Yoshiro Nakayama Rei Chinen Tsugumi Uema Sawako Nakachi Shiki Okamoto Hiroaki Masuzaki |
| author_sort | Yohei Ishiki |
| collection | DOAJ |
| description | Post-traumatic pituitary stalk transection syndrome (PSTS) is an extremely rare cause of combined pituitary hormone deficiency (CPHD), affecting approximately 9 per 100,000 cases of traumatic brain injury. In contrast, pituitary stalk interruption syndrome (PSIS) is also a rare cause of CPHD. Importantly, these conditions are often confused due to their similar names and resembling findings on magnetic resonance imaging (MRI). PSIS has been thought to be a prenatal developmental event resulting from a couple of genetic aberrations. In typical PSIS, anterior pituitary hormone deficiencies are restricted to growth hormone (GH) and gonadotropin during the pediatric age, gradually and generally progressing to panhypopituitarism in most cases. In contrast, global deficiencies of the anterior pituitary hormones in PSTS are temporally associated with trauma. To the best of our knowledge, no case reports of PSTS combined with acute traumatic spinal cord injury have been reported. A 34-year-old female was transferred to our hospital after jumping from the fourth building floor. She was diagnosed as an acute traumatic spinal cord injury and underwent the operation of elective posterior spinal fusion. On postoperative day 7, the blood tests revealed considerable hyperkalemia, hyponatremia and eosinophilia. Notably, menstruation stopped after falling from a height. Pituitary function tests revealed GH deficiency, hypogonadism, hypothyroidism and hypoadrenocorticism. MRI revealed loss of the pituitary stalk, whilst the hyperintense signal from distal axon of hypothalamus was still identified. Based on these findings, she was diagnosed as PSTS. Our case highlights endocrinological landscape of transection of the pituitary stalk by acute trauma. |
| format | Article |
| id | doaj-art-94bc867a5dcb4b549d4212e20da8e97e |
| institution | Kabale University |
| issn | 1348-4540 |
| language | English |
| publishDate | 2024-08-01 |
| publisher | The Japan Endocrine Society |
| record_format | Article |
| series | Endocrine Journal |
| spelling | doaj-art-94bc867a5dcb4b549d4212e20da8e97e2025-01-22T05:14:16ZengThe Japan Endocrine SocietyEndocrine Journal1348-45402024-08-0171881782410.1507/endocrj.EJ24-0091endocrjPost-traumatic pituitary stalk transection syndrome (PSTS) expeditiously manifested after a fall from a height combined with acute traumatic spinal cord injury: a rare case report with review of literatureYohei Ishiki0Atsuko Tamaki1Ken-ichiro Honma2Ken Yonaha3Takamitsu Yabiku4Taiki Teruya5Moriyuki Uehara6Yoshiro Nakayama7Rei Chinen8Tsugumi Uema9Sawako Nakachi10Shiki Okamoto11Hiroaki Masuzaki12Division of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology, Second Department of Internal Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, JapanDivision of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology, Second Department of Internal Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, JapanDivision of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology, Second Department of Internal Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, JapanDivision of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology, Second Department of Internal Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, JapanDivision of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology, Second Department of Internal Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, JapanDivision of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology, Second Department of Internal Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, JapanDivision of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology, Second Department of Internal Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, JapanDivision of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology, Second Department of Internal Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, JapanDivision of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology, Second Department of Internal Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, JapanDivision of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology, Second Department of Internal Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, JapanDivision of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology, Second Department of Internal Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, JapanDivision of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology, Second Department of Internal Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, JapanDivision of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology, Second Department of Internal Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, JapanPost-traumatic pituitary stalk transection syndrome (PSTS) is an extremely rare cause of combined pituitary hormone deficiency (CPHD), affecting approximately 9 per 100,000 cases of traumatic brain injury. In contrast, pituitary stalk interruption syndrome (PSIS) is also a rare cause of CPHD. Importantly, these conditions are often confused due to their similar names and resembling findings on magnetic resonance imaging (MRI). PSIS has been thought to be a prenatal developmental event resulting from a couple of genetic aberrations. In typical PSIS, anterior pituitary hormone deficiencies are restricted to growth hormone (GH) and gonadotropin during the pediatric age, gradually and generally progressing to panhypopituitarism in most cases. In contrast, global deficiencies of the anterior pituitary hormones in PSTS are temporally associated with trauma. To the best of our knowledge, no case reports of PSTS combined with acute traumatic spinal cord injury have been reported. A 34-year-old female was transferred to our hospital after jumping from the fourth building floor. She was diagnosed as an acute traumatic spinal cord injury and underwent the operation of elective posterior spinal fusion. On postoperative day 7, the blood tests revealed considerable hyperkalemia, hyponatremia and eosinophilia. Notably, menstruation stopped after falling from a height. Pituitary function tests revealed GH deficiency, hypogonadism, hypothyroidism and hypoadrenocorticism. MRI revealed loss of the pituitary stalk, whilst the hyperintense signal from distal axon of hypothalamus was still identified. Based on these findings, she was diagnosed as PSTS. Our case highlights endocrinological landscape of transection of the pituitary stalk by acute trauma.https://www.jstage.jst.go.jp/article/endocrj/71/8/71_EJ24-0091/_html/-char/enpost-traumatic pituitary stalk transection syndrome (psts)pituitary stalk interruption syndrome (psis)acute traumatic spinal cord injurysecondary adrenal insufficiencycombined pituitary hormone deficiency |
| spellingShingle | Yohei Ishiki Atsuko Tamaki Ken-ichiro Honma Ken Yonaha Takamitsu Yabiku Taiki Teruya Moriyuki Uehara Yoshiro Nakayama Rei Chinen Tsugumi Uema Sawako Nakachi Shiki Okamoto Hiroaki Masuzaki Post-traumatic pituitary stalk transection syndrome (PSTS) expeditiously manifested after a fall from a height combined with acute traumatic spinal cord injury: a rare case report with review of literature Endocrine Journal post-traumatic pituitary stalk transection syndrome (psts) pituitary stalk interruption syndrome (psis) acute traumatic spinal cord injury secondary adrenal insufficiency combined pituitary hormone deficiency |
| title | Post-traumatic pituitary stalk transection syndrome (PSTS) expeditiously manifested after a fall from a height combined with acute traumatic spinal cord injury: a rare case report with review of literature |
| title_full | Post-traumatic pituitary stalk transection syndrome (PSTS) expeditiously manifested after a fall from a height combined with acute traumatic spinal cord injury: a rare case report with review of literature |
| title_fullStr | Post-traumatic pituitary stalk transection syndrome (PSTS) expeditiously manifested after a fall from a height combined with acute traumatic spinal cord injury: a rare case report with review of literature |
| title_full_unstemmed | Post-traumatic pituitary stalk transection syndrome (PSTS) expeditiously manifested after a fall from a height combined with acute traumatic spinal cord injury: a rare case report with review of literature |
| title_short | Post-traumatic pituitary stalk transection syndrome (PSTS) expeditiously manifested after a fall from a height combined with acute traumatic spinal cord injury: a rare case report with review of literature |
| title_sort | post traumatic pituitary stalk transection syndrome psts expeditiously manifested after a fall from a height combined with acute traumatic spinal cord injury a rare case report with review of literature |
| topic | post-traumatic pituitary stalk transection syndrome (psts) pituitary stalk interruption syndrome (psis) acute traumatic spinal cord injury secondary adrenal insufficiency combined pituitary hormone deficiency |
| url | https://www.jstage.jst.go.jp/article/endocrj/71/8/71_EJ24-0091/_html/-char/en |
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