Severe malnutrition and panhypopituitarism

  1. Ana M. Godoy-Reyes 1
  2. Carla Martín-Abreu 1
  3. J. Fernando Armas-González 1
  4. Lourdes GonzálezNavarrete 1
  5. Victor Vera-Delgado 1
  6. Candelaria Martín-González 1
  7. María J. Sánchez-Pérez 1
  8. Emilio González-Reimers 1
  1. 1 Servicio de Medicina Interna. Hospital Universitario de Canarias. Facultad de Medicina. Universidad de La Laguna
Journal:
Majorensis: Revista Electrónica de Ciencia y Tecnología

ISSN: 1697-5529

Year of publication: 2019

Issue: 15

Pages: 9-13

Type: Article

DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Majorensis: Revista Electrónica de Ciencia y Tecnología

Abstract

The effects of starvation on hormonal pituitary axis is controversial. In former observations on war prisoners performed eight decades ago, a clinical picture similar to Simmond’s cachexia was described. Nowadays, in developed countries, severe malnutrition is practically restricted to anorexia nervosa, degenerative neurological disturbances and, rarely, malabsorptive syndromes and terminal neoplastic disease. Especially in anorexia nervosa corticotropin levels are usually raised, and the behavior of the remaining hormones is erratic. On the other hand, several alcoholism may impair secretion of some pituitary hormones. We here present a case of an alcoholic patient with severe malnutrition secondary to chronic pancreatitis, who presented with severe depression of all the pituitary hormones, that recovered “spontaneously” only with pancreatic enzyme replacement and weight gain

Bibliographic References

  • Aumaitre O, Thieblot P, Dordain G. [Abdomino-crural contracture disclosing panhypopituitarism with malnutrition]. Ann Med Interne (Paris). 1982;133(8): 583-587
  • Chatzitomaris A, Hoermann R, Midgley JE, Hering S, Urban A, Dietrich B, Abood A, Klein HH, Dietrich JW. Thyroid Allostasis–Adaptive Responses of Thyrotropic Feedback Control to Conditions of Strain, Stress, and Developmental Programming. Front. Endocrinol. 8:163.
  • Cónsole GM1 , Jurado SB, Oyhenart E, Ferese C, Pucciarelli H, Gómez Dumm CLMorphometric and ultrastructural analysis of different pituitary cell populations in undernourished monkeys. Braz J Med Biol Res. 2001 Jan;34(1):65- 74.
  • Gonzalez Rozas M, Hernanz Roman L, Gonzalez DG, Pérez-Castrillón JL. Panhypopituitarism due to Absence of the Pituitary Stalk: A Rare Aetiology of Liver Cirrhosis. Case Rep Endocrinol. 2016;2016:9071097. doi: 10.1155/2016/9071097.
  • Gonzalez-Reimers E, Martinez-Riera A, Santolaria-Fernandez F, Conde-Martel A, Alvarez-Argüelles H, Santana-Herrera C, Rodriguez-Moreno F. Relative and combined effects of ethanol and protein deficiency on gonadal function and histology. Alcohol. 1994;11(5):355-60.
  • Herbert DC, Carrillo AJ. The hypophysealadrenal axis in the protein-calorie malnourished rat. Horm Metab Res. 1982 Apr;14(4):205-7.
  • Herbert DC, Yashiro T, Muraki T, Okano T, Hattori A, Suzuki T.Quantitative morphological analysis of the pituitary gland in protein-calorie malnourished rats. Anat Rec. 1993; 235(1):121-5.
  • Lawson EA, Holsen LM, Desanti R, Santin M, Meenaghan E, Herzog DB, Goldstein JM, Klibanski A.Increased hypothalamicpituitary-adrenal drive is associated with decreased appetite and hypoactivation of food-motivation neurocircuitry in anorexia nervosa.Eur J Endocrinol. 2013;169:639- 47.
  • Mendenhall CL, Anderson S, Weesner RE, Goldberg SJ, Crolic KA. Protein-calorie malnutrition associated with alcoholic hepatitis. Veterans Administration Cooperative Study Group on Alcoholic Hepatitis. Am J Med. 1984;76:211-22.
  • Nakashima T, Fuchigami T, Inoue K, Omae T.A possible case of hypothalamic hypofunction caused by prolonged malnutrition due to intestinal blind loop. Endocrinol Jpn. 1977;24:529-36
  • Ogura T, Kageyama J, Itano Y, Yamauchi T, Oishi T, Aita T, Hayakawa N, Ogasa T, Ota K, Ota Z, et al. Crohn's disease associated with growth hormone secretory dysfunction. Intern Med. 1995;34:112-7.
  • Perloff WH, Lasche EM, Nodine JH, Schneeberg NG, Vieillard CB. The starvation state and functional hypopituitarism. J Am Med Assoc. 1954;155:1307-13
  • Santolaria F, Pérez-Cejas A, Alemán MR, González-Reimers E, Milena A, de la Vega MJ, Martínez-Riera A, GómezRodríguez MA. Low serum leptin levels and malnutrition in chronic alcohol misusers hospitalized by somatic complications.Alcohol Alcohol. 2003;38:60-66.
  • Carbone SE, de Rondina DC, Mastronardi IO, Szwarcfarb BStarvation and dehydration: effect on hypothalamic monoamines and serum LH and prolactin. Gen Pharmacol. 1989;20(1):111-3.
  • Schuetz P, Peterli R, Ludwig C, Peters T. Fatigue, weakness, and sexual dysfunction after bariatic surgery - not an unusual case but an unusual cause. Obes Surg. 2004; 14:1025-8
  • Sultan M, Afzal M, Qureshi SM, Aziz S, Lutfullah M, Khan SA, Iqbal M, Maqsood SU, Sadiq N, Farid N. Etiology of short stature in children. J Coll Physicians Surg Pak. 2008; 18:493-7.
  • Tenorio Jimenez C, Montalvo Valdivieso A, López Gallardo G, Mcgowan B. Pituitary involvement in Wegener's granulomatosis: unusual biochemical findings and severe malnutrition. BMJ Case Rep. 2011; 7:2011. pii: bc 0220113850.
  • Valle-Murillo MA, Perez-Diaz I. Hepatopathy in an adult, secondary to congenital untreated panhypopituitarism and ectopic posterior pituitary gland. Indian J Endocrinol Metab. 2012; 16: 821–823.
  • Van Thiel DH, Caraceni P, De Maria N, Nadir A, Hassanein T, Nadir F. Panhypopituitarism in two cirrhotics: clinical presentation and liver disease associations.J Okla State Med Assoc. 1995;88:299-304.
  • Van Thiel DH, Lester R Alcoholism: its effect on hypothalamic pituitary gonadal function.Gastroenterology 1976 ;71:318- 27
  • Vollmer EP. Relation of Hypopituitarism and starvation. Nature 1943; 151:698-699.
  • Yanai H, Yoshida H, Tomono Y, Tada N.Severe hypoglycemia in a patient with anorexia nervosa. Eat Weight Disord. 2008;13: e1-3.
Data source: Dialnet