Case of pituitary stalk transection syndrome ascertained after breech delivery

Fukuta, Kaori; Hidaka, Takao; Ono, Yosuke; Kochi, Keiko; Yasoshima, Kuniaki; Arai, Takashi

doi:10.1111/jog.12864

Cited by 5 publications

(4 citation statements)

References 13 publications

(17 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…She did not visit our hospital for 5 years from age 15 until age 20 but returned to the Department of Obstetrics and Gynecology because of primary amenorrhea. She succeeded in becoming pregnant after several inductions of ovulation and delivered a healthy male baby weighing 2,795 g, as described by Fukuta et al (7). She received GHRT again 10 months after the first delivery from her primary care doctor (Table 1).…”

Section: Case Reportmentioning

confidence: 81%

Successful Pregnancies and Deliveries in a Patient With Evolving Hypopituitarism due to Pituitary Stalk Transection Syndrome: Role of Growth Hormone Replacement

et al. 2017

Self Cite

View full text Add to dashboard Cite

We herein report a 31-year-old Japanese woman with evolving hypopituitarism due to pituitary stalk transection syndrome. She had a history of short stature treated with growth hormone (GH) in childhood and had hypothyroidism and primary amenorrhea at 20 years old. Levothyroxine replacement and recombinant follicle stimulating hormone-human chorionic gonadotropin (FSH-hCG) therapy for ovulation induction were started. GH replacement therapy (GHRT) was resumed when she was 26 years old. She developed mild adrenocortical insufficiency at 31 years old. She succeeded in becoming pregnant and delivered twice. GHRT was partially continued during pregnancy and stopped at the end of the second trimester without any complications.

show abstract

Section: Case Reportmentioning

confidence: 81%

Successful Pregnancies and Deliveries in a Patient With Evolving Hypopituitarism due to Pituitary Stalk Transection Syndrome: Role of Growth Hormone Replacement

et al. 2017

Self Cite

View full text Add to dashboard Cite

show abstract

“…In a reported case of a pair of twins, the firstborn twin diagnosed with PSIS and posterior lobe ectopia experienced breech presentation and difficult labor, while the second twin, without any perinatal events, did not exhibit posterior lobe ectopia or PSIS (29). These findings strongly suggest that the potential injury secondary to traction during delivery may be a direct cause of PSIS (75). Regardless of fetal position, if there is sufficient traction during delivery, it can lead to upward retraction of the extending posterior lobe.…”

Section: Our Gene Analysis Based On Literaturementioning

confidence: 85%

Re-analysis of gene mutations found in pituitary stalk interruption syndrome and a new hypothesis on the etiology

Wang,

Qin,

Jiang

et al. 2024

Front. Endocrinol.

View full text Add to dashboard Cite

BackgroundPituitary stalk interruption syndrome (PSIS) is a complex clinical syndrome characterized by varied pituitary hormone deficiencies, leading to severe manifestations across multiple systems. These include lifelong infertility, short stature, mental retardation, and potentially life-threatening pituitary crises if not promptly diagnosed and treated. Despite extensive research, the precise pathogenesis of PSIS remains unclear. Currently, there are two proposed theories regarding the pathogenic mechanisms: the genetic defect theory and the perinatal injury theory.MethodsWe systematically searched English databases (PubMed, Web of Science, Embase) and Chinese databases (CNKI, WanFang Med Online, Sinomed) up to February 24, 2023, to summarize studies on gene sequencing in PSIS patients. Enrichment analyses of reported mutated genes were subsequently performed using the Metascape platform.ResultsOur study included 37 articles. KEGG enrichment analysis revealed mutated genes were enriched in the Notch signaling pathway, Wnt signaling pathway, and Hedgehog signaling pathway. GO enrichment analysis demonstrated mutated genes were enriched in biological processes such as embryonic development, brain development, axon development and guidance, and development of other organs.ConclusionBased on our summary and analyses, we propose a new hypothesis: disruptions in normal embryonic development, partially stemming from the genetic background and/or specific gene mutations in individuals, may increase the likelihood of abnormal fetal deliveries, where different degrees of traction during delivery may lead to different levels of pituitary stalk interruption and posterior lobe ectopia. The clinical diversity observed in PSIS patients may result from a combination of genetic background, specific mutations, and variable degrees of traction during delivery.

show abstract

“…Wang et al studied 59 cases of children with PSIS, of which 54 cases had breech deliveries [10]. Fukuta et al have supported the idea that breech presentation is a risk factor for pituitary stalk transection syndrome [11]. Recently, three holoprosencephaly (HPE)-related genes (SHH, TGIF, and SIX3) were found to be linked with PSIS.…”

Section: Discussionmentioning

confidence: 99%

Short Stature: Think About the Pituitary Stalk Interruption Syndrome

Mniai¹,

Bourial²,

Salam³

et al. 2023

Cureus

View full text Add to dashboard Cite

Pituitary stalk interruption syndrome (PSIS) is an uncommon congenital defect of the pituitary gland. It is considered one of the rare endocrinal causes of abnormally short stature. Herein, we present a case of a four-year-old girl who consulted for short stature and delayed growth. The patient's history did not include any past medical or surgical pathology. Birth history revealed a full-term delivery with a breech presentation. Clinically, the patient had a small stature, beneath the third percentile. Magnetic resonance imaging findings, through a typical triad, were consistent with PSIS. We describe through this report, what we believe is a rare typical case of PSIS. This case was discovered in a young patient with pituitary dwarfism. We hope that the concise and synthesized structure of this case report will help physicians acquire the necessary reflexes to notice and diagnose the already underdiagnosed PSIS.

show abstract

Case of pituitary stalk transection syndrome ascertained after breech delivery

Cited by 5 publications

References 13 publications

Successful Pregnancies and Deliveries in a Patient With Evolving Hypopituitarism due to Pituitary Stalk Transection Syndrome: Role of Growth Hormone Replacement

Successful Pregnancies and Deliveries in a Patient With Evolving Hypopituitarism due to Pituitary Stalk Transection Syndrome: Role of Growth Hormone Replacement

Re-analysis of gene mutations found in pituitary stalk interruption syndrome and a new hypothesis on the etiology

Short Stature: Think About the Pituitary Stalk Interruption Syndrome

Contact Info

Product

Resources

About