View source for Pickardt syndrome

{{short description|Rare form of tertiary hypothyroidism}}
{{Infobox medical condition (new)
| name            = Pickardt–Fahlbusch syndrome
| synonyms        = '''Pickardt's syndrome''' or '''Pickardt–Fahlbusch syndrome'''
| image           = Grays_pituitary.png
| caption         = An interupption of the [[hypophyseal portal system]] causes Pickardt's syndrome
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| named after     = {{ubl|[[Renate Pickardt]]|Rudolf Fahlbusch}}
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'''Pickardt syndrome'''  denotes a rare form of tertiary [[hypothyroidism]] that is caused by interruption of the [[Hypophyseal portal system|portal veins]] connecting [[hypothalamus]] and [[pituitary]].It was characterized in 1972 and 1973 by [[Renate Pickardt]] and [[Rudolf Fahlbusch]].<ref>{{cite journal | vauthors = Pickardt C, Fahlbusch R | title = Chronic hyperosmolality, adipsia and secondary insufficiency of the anterior pituitary gland in hypothalamic lesions | journal = Internist (Berl) | volume = 13 | issue = 2 | pages = 45–51 | year = 1972 | pmid = 4554749}}</ref><ref>{{cite journal | doi = 10.1111/j.1365-2362.1973.tb00351.x | author = Pickardt, C. R. | author2 = Erhardt, F. | author3 = Fahlbusch, R. | author4 = Scriba, P. C. | name-list-style = amp | title = Portal Vessels Occlusion. A Cause for Pituitary Insufficiency in Patiens with Pituitary Tumors | journal =  European Journal of Clinical Investigation | volume = 3 | pages = 262 | year = 1973 | url = http://www3.interscience.wiley.com/journal/120072487/abstract | archive-url = https://archive.today/20130105103143/http://www3.interscience.wiley.com/journal/120072487/abstract | url-status = dead | archive-date = 2013-01-05 | issue = 3 |issn = 0014-2972| url-access = subscription }}</ref>

==Signs and symptoms==
{{Empty section|date=May 2022}}
==Cause==
Interruption of the portal system may be caused by [[tumor]]s compressing the infundibulum. Other causes for Pickardt's syndrome are [[Inflammation|inflammatory disorders]] and [[traumatic brain injury]]. An inborn variant of Pickardt's syndrome that is associated with certain mutations ([[HESX1]]<ref>{{cite journal | author = Reynaud R, Albarel F, Saveanu A, Kaffel N, Castinetti F, Lecomte P, Brauner R, Simonin G, Gaudart J, Carmona E, Enjalbert A, Barlier A, Brue T | title = Pituitary Stalk Interruption Syndrome in 83 patients: novel HESX1 mutation and severe hormonal prognosis in malformative forms | journal = Eur J Endocrinol | volume = 164| issue = 4| pages = 457–65| pmid = 21270112 | doi = 10.1530/EJE-10-0892 | date = April 2011 | doi-access =  }}</ref> or [[LHX4]]) is referred to as ''pituitary stalk interruption syndrome (PSIS)''.

===Endocrine consequences===
Typical manifestations of Pickardt–Fahlbusch syndrome are hypothyroidism with reduced [[Thyrotropin|TSH]] values and functional [[hyperprolactinemia]] (which is caused by disinhibition of [[prolactin]] release). Other [[endocrine]] disorders that are usually associated with Pickardt syndrome are suprasellar failures like secondary [[hypogonadism]], reduced levels of [[growth hormone]] and, in more severe cases, secondary [[adrenal insufficiency]].{{citation needed|date=August 2020}}

==Diagnosis==
Pickardt's syndrome may cause difficulties in differential diagnosis of [[pituitary adenoma]]s, as both suprasellar hormone-inactive adenomas and [[prolactinoma]]s may be associated with increased prolactin levels, central hypogonadism and central hypothyroidism. Usually, the prolactin levels are higher in case of a true prolactinoma, but the concentration ranges overlap.{{citation needed|date=August 2020}}

==Treatment==
Treatment modality depends on the cause. Tumors may be removed surgically, but pituitary stalk interruption may persist. Usually, replacement of those [[hormone]]s that are reduced due to failed [[feedback control]] systems will be necessary.{{citation needed|date=August 2020}}

==References==
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== External links ==
{{Medical resources
|  DiseasesDB     = 6314
|  ICD10          = {{ICD10|E|23|}}
|  ICD9           = {{ICD9|253.7}}
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|  MeshID         = 68006966
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{{Thyroid disease}}
{{Transcription factor/coregulator deficiencies}}

[[Category:Endocrine diseases]]
[[Category:Diseases named after discoverers]]