TRUE PITUITARY ADDISON'S DISEASE—A PITUITARY UNITROPIC DEFICIENCY (FIFTEEN-YEAR FOLLOW-UP)*

Abstract

THE authors introduce the term “unitropism” in this paper to designate a selective involvement of a single tropic hormone of the pituitary gland. The implication of the unitropic concept has been considered in such conditions as pituitary myxedema (1, 2), pituitary dwarfism (1a, 3), and pituitary hypogonadism (1b, 4, 5). Although isolated instances of unitropism may be gleaned from the literature, a clear concept has not been evolved. Such a concept is more difficult to establish, since this is an exclusion diagnosis. In order to establish the validity of a case of hypopituitary unitropism, a deficiency of a single tropic hormone must be demonstrated. Thus, for example, although the outstanding signs and symptoms in panhypopituitarism may be those of hypogonadism, the presence of secondary hypothyroidism and hypoadrenia precludes the unitropic diagnosis. The further purpose of this paper is to present the first established case of true pituitary Addison's disease with acceptable diagnostic criteria (Tables 1 and 2). Although the term pituitary Addison's disease is not a new one, its previous use has been related to the predominance of addisonian symptoms in panhypopituitarism rather than to the more restricted definition as given here.