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Congenital hypopituitarism and conjugated hyperbilirubinemia in two infants.

Congenital hypopituitarism in children is a well-recognized entity. 1-10 The association of severe neonatal hypoglycemia with growth hormone or adrenocorticotropin insufficiency and with the presence of a microphallus and cryptorchidism in some of the male patients is well established. 6-8 Hepatomegaly and jaundice have been found in some of these patients. 8,9 However, the association of hypopituitarism with conjugated hyperbilirubinemia has been previously documented in only one report. 10 We have recently encountered two infants with hypopituitarism and hypoglycemia, both of whom also had an increased direct serum bilirubin level. Report of Cases .—Case 1.—This patient was born after 45 weeks' gestation to a 23-year-old para 0 woman by cesarean section for cephalopelvic disproportion. Apgar scores were 3 and 5 at one and five minutes, respectively, for which the infant required oxygen. Physical examination showed a 4.6-kg male infant, 53 cm in length, with polydactyly and microphallus. Stretched length of