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Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 28, 2020; 26(44): 6909-6922
Published online Nov 28, 2020. doi: 10.3748/wjg.v26.i44.6909
Pituitary stalk interruption syndrome and liver changes: From clinical features to mechanisms
Ze-Yu Wu, Yi-Ling Li, Bing Chang
Ze-Yu Wu, Yi-Ling Li, Bing Chang, Department of Gastroenterology, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
Author contributions: Wu ZY wrote the manuscript; Li YL and Chang B participated in the critical revision of the manuscript; all of the authors approved the final manuscript.
Supported by The Innovative Talent Support Program of The Institution of Higher Learning in Liaoning Province, No. 2018-478; and The Innovative Talents of Science and Technology Support Program of Young and Middle People of Shenyang, No. RC170446.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Bing Chang, MD, Chief Doctor, Department of Gastroenterology, The First Affiliated Hospital of China Medical University, No. 155 Nanjing North Street, Heping District, Shenyang 110001, Liaoning Province, China. cb000216@163.com
Received: July 28, 2020
Peer-review started: July 28, 2020
First decision: September 30, 2020
Revised: October 14, 2020
Accepted: October 27, 2020
Article in press: October 27, 2020
Published online: November 28, 2020
Processing time: 122 Days and 4.6 Hours
Abstract

Pituitary stalk interruption syndrome (PSIS) is a rare congenital abnormality characterized by thinning or disappearance of the pituitary stalk, hypoplasia of the anterior pituitary and an ectopic posterior pituitary. Although the etiology of PSIS is still unclear, gene changes and perinatal adverse events such as breech delivery may play important roles in the pathogenesis of PSIS. PSIS can cause multiple hormone deficiencies, such as growth hormone, which then cause a series of changes in the human body. On the one hand, hormone changes affect growth and development, and on the other hand, they could affect human metabolism and subsequently the liver resulting in nonalcoholic fatty liver disease (NAFLD). Under the synergistic effect of multiple mechanisms, the progression of NAFLD caused by PSIS is faster than that due to other causes. Therefore, in addition to early identification of PSIS, timely hormone replacement therapy and monitoring of relevant hormone levels, clinicians should routinely assess the liver function while managing PSIS.

Keywords: Pituitary stalk interruption syndrome; Hormone deficiency; Etiology; Liver change; Clinical characteristics; Mechanisms

Core Tip: Pituitary stalk interruption syndrome (PSIS) characterized by thinning or disappearance of the pituitary stalk, hypoplasia of the anterior pituitary and an ectopic posterior pituitary, could cause isolated pituitary hormone deficiency or combined pituitary hormone deficiency. In addition to influencing the growth and development of humans, PSIS could also lead to liver changes such as nonalcoholic fatty liver disease through many mechanisms. As a result, it is important to assess liver function of patients with PSIS.