Adenohypophyseal Changes in Patients Dying of Acute Renal Tubular Necrosis ‡

A method of studying the topographical distribution and cytological characteristics of the glandular cells of the human adenohypophysis was described in a previous report.' A cell classification based on probable functional significance was introduced in an attempt to achieve a greater degree of correlation between morphological and clinical observations. Application of this method to a group of normal adult and male adolescent glands revealed a predominance of storage cells in the adult, while adolescent glands showed evidence of increased secretory activity in both basophilic and acidophilic cells. These alterations, it was felt, reflected increased pubertal gonadotropic and growth hormone secretion. The present study is an evaluation of adenohypophyseal cytology in patients dying in uremia of acute tubular necrosis. The striking alterations observed in both acidophilic and basophilic cells are interpreted as the morphologic expression of altered pituitary function in response to acute malnutrition. Patients with acute renal disease warrant special consideration because all were in good health until the onset of renal failure and their clinical course was short and could be studied in detail. They represent, furthermore, the special problem of possible effects on the hypophysis of renal disease per se.