In 1914, Simmonds 1 described a pathologic condition which he designated "hypophysial cachexia." The patient was a woman, the anterior lobe of whose hypophysis was transformed into a mass of "cell-poor and elastin-poor connective tissue with small capillary spaces" containing a few cords or small groups of round cells. He believed that the lesion was the result of a "septic necrosis" of the hypophysis due to a severe puerperal sepsis occurring eleven years before death. In 1916, Fraenkel2 reported an essentially similar case. Simmonds 3 later added four cases, and, in 1923, Jakob 4 described two more. These eight cases showed a definite clinical picture characterized by chronic cachexia with marked atrophy of the internal organs, as in senility; wrinkling of the skin of the face; loss of the teeth; stoppage of menstruation (all of these patients were women), and loss of axillary and pubic hair. The one constant
SIMONDS JP, BRANDES WW. PATHOLOGY OF THE HYPOPHYSIS: III. CHRONIC HYPOPHYSITIS; FIBROSIS. JAMA. 1925;84(19):1408–1410. doi:10.1001/jama.1925.02660450016010
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