Endocrine Abstracts

Introduction: The ectopic posterior pituitary is a rare condition which is characterized by the ectopic location of posterior lobe of pituitary, pituitary stalk abnormalities, and associated clinical manifestations of anterior lobe related growth hormone dysfunction or less commonly multiple anterior pituitary dysfunctions. We describe the case of a young female who presented with short stature and was found to have ectopic posterior pituitary.

Case presentation: A 17-year-old young female presented with short stature and amenorrhea. Her siblings and parents were healthy, with normal height. An examination showed her blood pressure was 90/60 mmHg, and her height, weight, and body mass index were 147 cm, 34 kg, and 15.73 kg/m², respectively. She had a B5 P3 Tanner Stage. Our patient showed no signs of diabetes insipidus. Her lab investigations showed that her thyroid stimulating hormone (TSH) was 2.4 uIU/ml (0.34 to 5.6), her free thyroid hormone level FT4 was 6 pmol/l (7.9 to 14.4), her prolactin was 157 mIU/l (70 to 566), and her baseline cortisol was 153 ng/ml (60 to 184). Her insulin like growth factor IGF-1 was 84 ng/ml (247.3 to 481.7), her Estradiol level was 43 ng/dl, her follicle stimulating hormone FSH was 10.08 uIU/ml, and her leutinizing hormone LH was 6.87 uIU/ml. A clonidine Stimulation test was conducted, and growth hormone(GH) serum levels were measured at 30, 60, and 120 minutes. The results showed a GH deficiency with a peak cut-off value of 10 μg/l. Her bone age was 17 years according to the Greulich and Pyle method, as shown by X-rays. The results from her pituitary magnetic resonance imaging scan were consistent with ectopic posterior lobe of pituitary gland.

Conclusion: Despite the fact that structural malformations in hypothalamo-pituitary region are a rare disorder, it should always be kept in the differential diagnosis of a patient presenting with short stature. Patients with this disease have an excellent opportunity to reach normal height if they present before the joining of epiphyses.