Hereditary pituitary hyperplasia with infantile gigantism

Sven Gläsker, Alexander O. Vortmeyer, Antony R.A. Lafferty, Paul L. Hofman, Jie Li, Robert J. Weil, Zhengping Zhuang, Edward H. Oldfield

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Context: We report hereditary pituitary hyperplasia. Objective: The objective of the study was to describe the results of the clinical and laboratory analysis of this rare instance of hereditary pituitary hyperplasia. Design: The study is a retrospective analysis of three cases from one family. Setting: The study was conducted at the National Institutes of Health, a tertiary referral center. Patients: A mother and both her sons had very early-onset gigantism associated with high levels of serum GH and prolactin. Interventions: The condition was treated by total hypophysectomy. Main Outcome Measure(s): We performed clinical, pathological, and molecular evaluations, including evaluation basal and provocative endocrine testing, neuroradiological assessment, and assessment of the pituitary tissue by microscopic evaluation, immunohistochemistry, and electron microscopy. Results: All three family members had very early onset of gigantism associated with abnormally high serum levels of GH and prolactin. Serum GHRH levels were not elevated in either of the boys. The clinical, radiographic, surgical, and histological findings indicated mammosomatotroph hyperplasia. The pituitary gland of both boys revealed diffuse mammosomatotroph hyperplasia of the entire pituitary gland without evidence of adenoma. Prolactin and GH were secreted by the same cells within the same secretory granules. Western blot and immunohistochemistry demonstrated expression of GHRH in clusters of cells distributed throughout the hyperplastic pituitary of both boys. Conclusions: This hereditary condition seems to be a result of embryonic pituitary maldevelopment with retention and expansion of the mammosomatotrophs. The findings suggest that it is caused by paracrine or autocrine pituitary GHRH secretion during pituitary development.

Original languageEnglish (US)
Pages (from-to)E2078-E2087
JournalJournal of Clinical Endocrinology and Metabolism
Volume96
Issue number12
DOIs
StatePublished - Dec 1 2011

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Gigantism
Prolactin
Hyperplasia
Pituitary Gland
Serum
Immunohistochemistry
Hypophysectomy
Electron microscopy
Secretory Vesicles
National Institutes of Health (U.S.)
Nuclear Family
Cells
Tertiary Care Centers
Health
Adenoma
Tissue
Electron Microscopy
Western Blotting
Mothers
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Gläsker, S., Vortmeyer, A. O., Lafferty, A. R. A., Hofman, P. L., Li, J., Weil, R. J., ... Oldfield, E. H. (2011). Hereditary pituitary hyperplasia with infantile gigantism. Journal of Clinical Endocrinology and Metabolism, 96(12), E2078-E2087. https://doi.org/10.1210/jc.2011-1401

Hereditary pituitary hyperplasia with infantile gigantism. / Gläsker, Sven; Vortmeyer, Alexander O.; Lafferty, Antony R.A.; Hofman, Paul L.; Li, Jie; Weil, Robert J.; Zhuang, Zhengping; Oldfield, Edward H.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 96, No. 12, 01.12.2011, p. E2078-E2087.

Research output: Contribution to journalArticle

Gläsker, S, Vortmeyer, AO, Lafferty, ARA, Hofman, PL, Li, J, Weil, RJ, Zhuang, Z & Oldfield, EH 2011, 'Hereditary pituitary hyperplasia with infantile gigantism', Journal of Clinical Endocrinology and Metabolism, vol. 96, no. 12, pp. E2078-E2087. https://doi.org/10.1210/jc.2011-1401
Gläsker, Sven ; Vortmeyer, Alexander O. ; Lafferty, Antony R.A. ; Hofman, Paul L. ; Li, Jie ; Weil, Robert J. ; Zhuang, Zhengping ; Oldfield, Edward H. / Hereditary pituitary hyperplasia with infantile gigantism. In: Journal of Clinical Endocrinology and Metabolism. 2011 ; Vol. 96, No. 12. pp. E2078-E2087.
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