Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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February 25, 2016
Pituitary Siderosis
- Background:
- Iron overload usually involves the reticulo-endothelial system, heart, and endocrinal glands. Iron accumulates in the 5 cell types of adenohypophysis but preferentially in the gonadotropin secreting cells.
- Clinical Presentation:
- Typical clinical presentation is hypogonadotropic hypogonadism and, less commonly, growth hormone deficiency.
- Panhypopituitarism may appear in cases of severe pituitary siderosis.
- Key Diagnostic Features:
- MRI: Pituitary height loss. Decreased signal intensity of adenohypophysis on T1WI and mainly on T2WI.
- Gradient echo T2*-weighted sequence also shows decreased signal of the pituitary gland, and at an early stage of the disease.
- Elevated ferritin blood level
- Treatment:
- This condition is usually not reversible. Prevention with iron chelators and symptomatic treatment of hormonal deficiency is recommended.
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