Authors : Abdullahi Ibrahim; Zubairu Umar; Adebayo Adebisi Sunday; Abubakar Baguda Sulaiman; Abdulaziz Hadi Ibrahim; Junaidu Sarki; Shamsudeen Nasiru Shehu

Volume/Issue : Volume 11 - 2026, Issue 5 - May

Google Scholar : https://tinyurl.com/bd4pftu7

Scribd : https://tinyurl.com/3dzze3e5

DOI : https://doi.org/10.38124/ijisrt/26May1703

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Abstract : Background: Disorders affecting the hypothalamic-pituitary axis may present with prominent psychiatric symptoms, including psychosis. In low resource settings, limited access to neuroimaging, endocrine assays, and specialist review can delay recognition of an underlying organic cause.  Objective: To report a young adult male with untreated childhood onset growth hormone deficiency, hypogonadotropic hypogonadism, and mild hyperprolactinemia who presented primarily with chronic psychosis, and to highlight the diagnostic, therapeutic, and genetic implications of this presentation.  Case Presentation: A 24 year old male had a 3 year history of progressive paranoid ideas, visual hallucinations, social withdrawal, insomnia, and depressive symptoms. Physical examination showed severe short stature, low body mass index, micropenis, and absence of secondary sexual characteristics. Laboratory evaluation revealed markedly reduced insulin like growth factor 1 and insulin like growth factor binding protein 3, very low gonadotropin and testosterone levels, and mildly raised prolactin. A five generation pedigree showed earlier consanguineous unions, supporting a possible recessive neuroendocrine disorder.  Outcome: Treatment with haloperidol and flupenthixol produced partial improvement in sleep, self care, and social functioning, but the central paranoid belief persisted. The endocrine and psychiatric profile remained most consistent with hypothalamic-pituitary disease, either congenital or structural.  Conclusion: Severe short stature, absent pubertal development, multiple pituitary hormone abnormalities, visual hallucinations, and poor response of core delusional content should prompt investigation for organic causes of psychosis. Early multidisciplinary assessment is especially important where delayed diagnosis can lead to prolonged disability.

Keywords : Psychosis; Growth Hormone Deficiency; Hypogonadotropic Hypogonadism; Hyperprolactinemia; Pituitary Disorder; Organic Psychosis; Consanguinity; Low Resource Setting

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