[Pituitary deficiency of elderly subject: analysis of 14 cases]

The pituitary deficiency [PD] of the old subject is rare. To study the clinical biological etiologic and therapeutic characteristicsof PD in old subject. We report in this work a retrospective study of 14 patients older than 65 years presenting pituitary deficiency. This PD is characterized by a female preponderance [78, 5%of cases] and insidious initial symptomatology dominated by signs of thyreotrope deficiency and with a less degree of the signs of corticotrope sufficiency Anaemia [57, 5%] hypoglycaemia [28, 5%] and hyponatremia [21, 4%] are the most frequent biological signs. Hormonal exploration showed a dissociated pituitaiy deficiency in 11 cases [782 and global in 3 cases [21, 5%] The axis more touched is the gonadotrope axis [85, 7%] followed by the corticotrope [71, 4%] and thyreotrope axis [71, 4%]. The aetiologies are dominated by the Sheehan syndrome in 5 cases [35, 7%] followed by the hypophysis adenoma m 4 case [21, 4%]. The pituitary deficiency was idiopathic probably of vascular ongin in 2 cases [14, 28%] and secondary to primitive turcic saddle in 1 cases to a cyst of the pocket of Rathke in I case and to prolonged corticotherapy in 1 case. The hormonal substitutive treatment hare per-miffed a spectacular improvement in all the cases. It is necessary to think about the PD in the old subjects in front of minor signs and at the vascular ongin of this one witch remains the most frequent aetiology at the old subject especially those presenting atherogens factors

[Congenital pituitary stalk interruption syndrome-Report of 6 cases]

Pituitary stalk interruption is a non-negligible cause of growth hormone [GH] deficiency. We report 6 cases [5 boys and 1 girl] with complete congenital GH deficiency. The average age was 13 years. 4 out of 6 cases [66, 6%] had corticotrophic hormone deficiency; 1 of 6 cases [16, 6%] had a hypothyroidism. 2 out of 4 children older than normal age of puberty had gonadotropin deficiency [50%]. Diabetes insipidus was not prsent and hyperprolcatinemia was present in 2 cases. 4 children had past history of fetal distress. Pituitary stalk interruption was assessed by the means of magnetic resonance imaging [MRI]. The cause of the stalk interruption syndrome is unknown. The MRI in this syndrome revealed ectopic posterior lobe location, stalk interruption and hypoplastic anterior-lobe. The outcome is progressive evolution towards panhypopituitarism and these patients require regular clinical survey and hormonal controls