Survey Studies on Pituitary Diseases in Japan

Abstract

This paper represents the results of survey of pituitary diseases in Japan during the 10-year period between 1965 and 1974. All patients who were examined or treated in Japanese general hospitals with more than 80 beds were studied by letters of inquiry. From the study, it was estimated that the total number of patients was as follows: 1130 cases of pituitary dwarfism, 1908 cases of hypopituitarism, 917 cases of acromegaly and gigantism, 745 cases of Cushing's disease (adrenal hyperplasia), 1668 cases of pituitary diabetes insipidus. Detailed information was obtained on about half of these patients.
Among patients with pituitary dwarfism, 84% were idiopathic. Idiopathic cases were observed far more frequently in male patients, while no sexual dominancy was observed in secondary cases. In idiopathic cases, the incidence in pathological conditions at the time of delivery was high. Among secondary cases, the predominant causes we crareniopharyngioma and pinealoma. In adult males with hypopituitarism, 42% were due to pituitary adenomas, 19% to craniopharyngiomas and 14% to pinealomas; in adult females, 42% were due to Sheehan's disease, 30% to pituitary adenomas, 12% to craniopharyngiomas and only 3% to pinealomas. In patients with acromegaly, the male to female ratio was 1.2: 1; histologically, 72% were acidophilic, 13% chromophobe and 15% mixed pituitary adenomas. In this survey of Cushing's disease, Cushing's syndrome due to adrenal tumor was 2: 1. The male to female ratio was 1: 3.3 in hyperplasia and 1: 3.9 in adrenal tumor. In patients with pituitary diabetes insipidus, 55% were secondary, 45% idiopathic and 2% familial. The sex ratio between males and females was 1.4: 1. As causes of secondary cases, 25% were due to pinealomas, 16% craniopharygiomas, 13% trauma and 11% other brain tumors.
It was assumed that most of the diagnosed patients were included in this survey; however, an unknown number of patients were escaped, either because they had been misdiagnosed as other diseases, or because they had not yet received a medical examination.