Pituitary changes in Kallmann's syndrome: a histologic, immunocytologic, ultrastructural, and immunoelectron microscopic study.

Pituitary cytology was studied in a man with untreated Kallmann's syndrome who died at the age of 61. All the adenohypophyseal cells were normal except the gonadotrophs. The identifiable gonadotrophs were scanty and had few and small secretory granules, which gave a weak positivity for beta -follicle-stimulating hormone (FSH) and beta -luteinizing hormone (LH). The tests showed marked hypogenesis, while the adrenals and the thyroid were normal. In the hypothalamus, the lateral tuberal nuclei were undeveloped, and the nucleus subventricularis exhibited nerve cell hypertrophy. The morphologic findings are in accord with the results of endocrine investigations, which showed that the hypogonadism was due to a failure in the secretion of luteinizing hormone-releasing hormone.

[The clinical picture of postpartum hypopituitarism]. / Das klinische Bild beim Post-Partum-Hypopituitarismus.

Hypopituitarism depends on the history of the obstetric cause, on the subsequent amenorrhoea and the usual absence of lactation, on the biochemical abnormalities found later, and on the effect of therapy. Nevertheless, an initial clinical inspection of the untreated patient gives important clues to the diagnosis. Cachexia does not occur in true hypopituitarism, unless there is some intercurrent factor which causes emaciation, such as carcinoma, tuberculosis, ulceration in the alimentary tract etc.