Wasting syndrome with deep bradycardia as presenting manifestation of long-standing severe male hypogonadotropic hypogonadism: a case series

BMC Endocrine Disorders

Sabrina Corbetta³  Luca Persani¹  Francesco Dangelo²  Marco Bonomi⁴  Elena Passeri³ 

[1] Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Department of Clinical Science and Community Health, University of Milan, Piazzale Brescia 20, 20149 Milan, Italy;Division of Internal Medicine, Cernusco sul Naviglio Hospital, Via Uboldo 21, 20063 Cernusco sul Naviglio, Milan, Italy;Endocrinology and Diabetology Unit, Department of Biomedical Sciences for Health, University of Milan, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato M.se, Milan, Italy;Division of Endocrine and Metabolic Diseases and Laboratory of Endocrine-Metabolic Research, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149 Milan, Italy

关键词: Heart failure;    Hypopituitarism;    Bradycardia;    Hypogonadism;   

Others  :  1084961
DOI  :  10.1186/1472-6823-14-78

 received in 2014-09-01, accepted in 2014-09-23,  发布年份 2014

【 摘 要 】

Background

Physiological functioning of the testes is important for cardiac health besides for virilisation, physical strength, behavior and reproduction; moreover, hypogonadism has been demonstrated as a significant risk marker of increased all-cause and cardiovascular mortality.

Cases presentation

We reported two cases of long-standing hypogonadotropic hypogonadism presenting with wasting, bradycardia and heart failure. The two patients were admitted to emergency department for deep weakness, unresponsive anemia and severe bradycardia, requiring in one case the implanting of a monocameral pace-maker for treatment of heart failure. No previous cardiologic disorders were known and cardiac ischemia was ruled out in both patients. The first patient presented congenital hypogonadotropic hypogonadism combined with mild central hypothyroidism and growth hormone deficiency occurred in the peripubertal age, while the second one was diagnosed with isolated adult-onset severe central hypogonadism. Testosterone deficiency was the main feature in both patients as physical examination revealed clinical stigmata of hypogonadism and testosterone replacement induced a dramatic improvement of general condition. Genetic analysis of genes involved in hypogonadotropic hypogonadism failed to identify alterations.

Conclusion

Long-standing hypogonadism in males can be associated with life threatening body alterations including severe bradycardia and heart failure.

【 授权许可】

   
2014 Passeri et al.; licensee BioMed Central Ltd.

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