Pituitary Stem Interruption Syndrome (SITP) diagnosed in childhood in a case at the Center Hospitalier Universitaire de Libreville (CHUL)

Authors

  • Nesta Patricia ZIZA NGAILA Centre Hospitalier Universitaire de Libreville, Gabon.
  • Jocelyne DANHO Service d’Endocrinologie, Hopital Militaire d’Abidjan, Côte-d’Ivoire
  • Daniela NSAME Centre Hospitalier Universitaire de Libreville, Gabon.
  • Natacha BOUMAS Centre Hospitalier Universitaire Mère Enfant Fondation Jeanne Ebori, Libreville, Gabon
  • Gladys ANGUEZOMO Centre Hospitalier Universitaire de Libreville, Gabon.
  • Pegguy BILOGHE Centre Hospitalier Universitaire de Libreville, Gabon.

DOI:

https://doi.org/10.55677/IJCSMR/V2I12-01/2022

Keywords:

Growth retardation, Congenital hypogonadotropic hypogonadism, pituitary stalk interruption syndrome

Abstract

Interrupted pituitary stalk syndrome (PITS) is a hypothalamic-pituitary morphological abnormality characterized by a slender or absent pituitary stalk, anterior pituitary hypoplasia, and ectopic posterior pituitary. Hormonal assessment and imaging are crucial for the diagnosis, early management can improve the child's stature prognosis.

We report the case of an 8-year-old child seen in endocrinology consultation for growth retardation. His medical history revealed acute fetal distress at birth, neonatal jaundice, and numerous consultations in early childhood for this anomaly. The clinical examination found a statural delay of -3DS, bilateral cryptorchidism, with small testicles. The hormonal balance found multiple pituitary deficits and Magnetic Resonance Imaging showed an absence of the pituitary stalk, anterior pituitary hypoplasia, and ectopia of the posterior pituitary. Deficient hormone supplementation was instituted. This case relates the typical picture of hypopituitarism by the absence of the pituitary stalk in a context where the disease is probably underdiagnosed due to lack of technical support in sub-Saharan Africa and little known. This explains the diagnostic error in our case, moreover, it allows us to pay particular attention to the meticulous monitoring of the growth of children who have presented perinatal anomalies, and the multidisciplinary exploration in the event of growth disorders.

References

Bar, C., Zadro, C., Diene, G., Oliver, I., Pienkowski, C., Jouret, B., Cartault, A., Ajaltouni, Z., Salles, J.-P., Sevely, A., 2015. Pituitary stalk interruption syndrome from infancy to adulthood: clinical, hormonal, and radiological assessment according to the initial presentation. PLoS One 10, e0142354.

Boueilh, T., Bassi, C., Rouleau, S., le Crugel, S., Moal, V., de Casson, F.B., Coutant, R., Mirebeau-Prunier, D., Reynier, P., Homedan, C., 2017. Le syndrome d’interruption de la tige pituitaire: une cause rare et sévère d’insuffisance hypophysaire À propos du diagnostic biologique d’un cas de découverte néonatale, in: Annales de Biologie Clinique. pp. 215–221.

Castets, S., Thomas-Teinturier, C., Villanueva, C., Saveanu, A., Coutant, R., Léger, J., Reynaud, R., 2022. Diagnostic et prise en charge du déficit hypophysaire congénital en pédiatrie. Perfectionnement en Pédiatrie.

Chen, S., Léger, J., Garel, C., Hassan, M., Czernichow, P., 1999. Growth hormone deficiency with ectopic neurohypophysis: anatomical variations and relationship between the visibility of the pituitary stalk asserted by magnetic resonance imaging and anterior pituitary function. J Clin Endocrinol Metab 84, 2408–2413.

Fujisawa, I., Kikuchi, K., Nishimura, K., Togashi, K., Itoh, K., Noma, S., Minami, S., Sagoh, T., Hiraoka, T., Momoi, T., 1987. Transection of the pituitary stalk: development of an ectopic posterior lobe assessed with MR imaging. Radiology 165, 487–489.

Marmouch, H., Graja, S., Arfa, S., Boubaker, F., Khochtali, I., 2016. Syndrome d’interruption de la tige pituitaire à révélation tardive. Pan African Medical Journal 23.

Miyamoto, J., HASEGAWA, Y., Ohnami, N., Onigata, K., Kinoshita, E., Nishi, Y., Tachibana, K., Hasegawa, T., 2001. Development of growth hormone and adrenocorticotropic hormone deficiencies in patients with prenatal or perinatal-onset hypothalamic hypopituitarism having invisible or thin pituitary stalk on magnetic resonance imaging. Endocr J 48, 355–362.

Parmentier, B., Peycelon, M., Maurin, S., Meyer, F., Audry, G., 2013. Chirurgie de l’ectopie testiculaire: de plus en plus tôt? Revues générales Chirurgie 33–36.

Riancho, J., Maione, L., Khalfi, K., Verdalle-Cazes, M., Scharbarg, E., Viry, C., Lefebvre, H., 2020. Syndrome d’interruption de la tige pituitaire à révélation tardive à l’âge adulte. À propos d’un cas, in: Annales d’Endocrinologie. Elsevier, pp. 297–298.

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Published

2022-12-08

How to Cite

ZIZA NGAILA, N. P. ., DANHO, J. ., NSAME, D. ., BOUMAS, N. ., ANGUEZOMO, G. ., & BILOGHE, P. . (2022). Pituitary Stem Interruption Syndrome (SITP) diagnosed in childhood in a case at the Center Hospitalier Universitaire de Libreville (CHUL). International Journal of Clinical Science and Medical Research, 2(12), 97–100. https://doi.org/10.55677/IJCSMR/V2I12-01/2022