DYSTROPHIA ADIPOSOGENITALIS 



877 



Other glands besides the pituitary and thyroid in which underdevelop- 

 ment and infantilism have been observed, both clinically and experimen- 

 tally, are the gonads, adrenals, thymus and pancreas. Many of the d.Mil.tt'ul 

 clinical cases are really of pituitary origin. Numerous cases obscure in 

 origin have recently appeared in the literature in which autopsies showed 

 gross pituitary lesions. Included in these reports are cases of the "Lorain" 

 (Levi, Rennie, Gushing) of the "Bris- 

 saud" (Leman, van Wart, Hewlett (a) 

 and of the "Paltauf" (Kraus) types. 

 There is a group of preadolescent cases of 

 hypopituitarism with skeletal overgrowth, 

 adiposity and hypogenitalism. The con- 

 dition has been described by Neurath, who 

 considers the basis for the syndrome a pri- 

 mary lesion of the gonads, and also by Gush- 

 ing (6) who interprets the phenomenon as 

 being due to heteroactivity of the pituitary 

 gland with excessive anterior lobe secretion 

 and diminished posterior lobe secretion. 



A distinguishing feature between infan- 

 tilism of the eunuchoid type (primary gen- 

 ital dystrophy) and the pituitary type (dys- 

 trophia adiposogenitalis) is that in the 

 former the epiphyseal closures of the long 

 bones are delayed much longer sometimes 

 throughout life than in the hypopituitary 

 state. This permits the extremities to grow 

 in length, out of proportion to the rest of 

 the body. Falta(c) suggested a simple 

 method of differentiation between the two 

 types based on these facts ; namely, the dis- 

 tance from the symphysis to the heel is 

 greater than from the symphysis to the top 

 of the head in primary genital dystrophy; 



whereas in primary dystrophia adiposogenitalis the upper measurements 

 exceed the lower. 



Simmonds(m) considers that the same process in the anterior lobe of 

 the pituitary which causes cachexia in the adult causes infantilism 

 in early life. He reports a case with autopsy findings, which shows 

 the character of the pituitary lesion and its effect on other glands 

 internal secretion and development of the genitalia. The case was a man 

 21 years old and 3y 2 feet tall. He was beardless and had no axi 

 or pubic hair. External genitalia were infantile in size. stieles 



were the size of peas, weighing respectively 0.9 gram and 1.2 grams. 



Fig. 8. Case of dystrophia 

 adiposogenitalis in a girl. (Per- 

 sonal observation.) 



