Missing Pituitary Stalk: A Key to the Diagnosis

摘要

A 17-year-old female patient referred to the outpatient department for an evaluation of her short stature. In her physical examination, weight and height were less than 3 percentile for age. Delayed puberty was diagnosed as Tanner breast and pubic hair stage II. Lab data showed normal results for complete blood count, thyroid function test, fasting blood sugar, and serum electrolytes. The hormonal assay revealed low levels of basal luteinizing and follicle-stimulating hormones, as well as abnormal insulin-like growth factor 1 (IGF-1), and growth hormone stimulation tests. Wrist X-ray was performed, that confirmed significantly delayed bone age.