One Case of Pituitary Stalk Interruption Syndrome Associated with Liver Cirrhosis

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.