Pituitary stalk interruption syndrome, also known as pituitary stalk transection syndrome, is a syndrome characterized by an absent or hypoplastic anterior pituitary gland, thin or absent infundibulum, and ectopic posterior pituitary location.
Pituitary stalk interruption syndrome is very rare with an estimated incidence of 0.5 in 1 million births 4.
Patients with pituitary stalk interruption usually present in the first decade of life with deficiency of growth hormones resulting in growth retardation 1. What can initially present as isolated growth hormone deficiency may progress to multiple pituitary hormones deficiencies with the eventual development of panhypopituitarism with preservation of posterior pituitary function 2,4.
The combination of hyperprolactinemia and hypothyroidism is known as Pickardt syndrome 4.
In addition to endocrinological manifestations, there appears to be an increased incidence of breech presentation and difficult delivery 4. A number of additional features may be encountered later in childhood including learning difficulties and seizures 4.
Various hypotheses have been proposed to explain the syndrome such as defective migration of the pituitary gland during intrauterine life or ischemia with subsequent reorganization of the infundibular axons and development of an ectopic posterior pituitary 1.
MRI is required for the diagnosis and demonstrates 4:
- absent/hypoplastic anterior pituitary gland
- thin or absent infundibulum
- ectopic posterior pituitary
Treatment and prognosis
Treatment consists of hormonal replacement 3.
- 1. Ioachimescu AG, Hamrahian AH, Stevens M et-al. The pituitary stalk transection syndrome: multifaceted presentation in adulthood. Pituitary. 2013;15 (3): 405-11. doi:10.1007/s11102-011-0337-9 - Pubmed citation
- 2. van der Linden AS, van Es HW. Case 112: pituitary stalk transection syndrome with ectopic posterior pituitary gland. Radiology. 2007;243 (2): 594-7. doi:10.1148/radiol.2432040385 - Pubmed citation
- 3. Kulkarni C, Moorthy S, Pullara SK et-al. Pituitary stalk transection syndrome: Comparison of clinico-radiological features in adults and children with review of literature. Indian J Radiol Imaging. 2012;22 (3): 182-5. doi:10.4103/0971-3026.107179 - Free text at pubmed - Pubmed citation
- 4. Gutch M, Kumar S, Razi SM, Saran S, Gupta KK. Pituitary stalk interruption syndrome: Case report of three cases with review of literature. (2014) Journal of pediatric neurosciences. 9 (2): 188-91. doi:10.4103/1817-1745.139363 - Pubmed