Simmonds’ cachexia

Mesenteric Endocrine artery Addison s disease Pseudo- Simmonds cachexia membranous... 

Hypopituitarism may involve all the hormones of the anterior hypophysis, or it may be restricted to one or a few hormones of the anterior lobe, depending on the patient s age. General hypopituitarism of the anterior lobe results in pituitary dwarfism, infantilism, and Simmonds cachexia. The restricted forms of hypopituitarism lead to well-known clinical syndromes such as Frohlich s and the Laurence-Moon-Biedl syndrome. 

Simmonds cachexia is often the consequence of anterior lobe necrosis due to its destruction by shock or septic emboli. The septic emboli may result from ascending pyelonephritis or from pyemia. Simmonds cachexia is observed more often in women than in men because obstetric shock seems to cause it frequently. But a progressive inflammatory process, the development of a chromophobe adenoma (often associated with compression of the chiasma and seizures), or hemorrhage within the gland should be considered as possible causes of Simmonds cachexia. 

In Simmonds cachexia, the secretion of all the stim-ulins elaborated by the anterior pituitary gland is interrupted, growth stops, and secretions from the thyroid, adrenal cortex, and gonads are partially abolished. 

The lack of growth hormones results in generalized atrophy of muscle (heart, skeletal muscle) and viscera (liver, kidney, spleen), and at autopsy the most typical finding in patients with Simmonds cachexia is micro-splanchnia. In most cases of Simmonds disease, the patient becomes dramatically cachectic with a severe negative nitrogen balance. 

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