Article
Clinical insights to pituitary adenomas among fairytale characters by Brothers Grimm
Klinische Einblicke – Märchenfiguren mit Hypophysenadenomen aus den Erzählungen der Brüder Grimm
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Authors
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Yawen Wang
- Vivantes Klinikum Friedrichshain, Klinik für Neurochirurgie, Berlin, Deutschland
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Dag Moskopp
- Vivantes Klinikum Friedrichshain, Klinik für Neurochirurgie, Berlin, Deutschland
| Published: | June 4, 2021 |
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Outline
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Objective: Grimm’s fairytales are known worldwide and everyone has encountered them at some point in time. Most of the characters are famous and known to be physically abnormal with e.g. giantism or prominent facial features. In fact, we wonder if these characters were inspired by people with pituitary diseases among the general population in the age of Brothers Grimm.
Methods: We systematically studied a collection of fairytales by the Brothers Grimm (edition 1937 by Karl Hobrecker). We defined typical neurological and endocrinological signs and symptoms possibly related to pituitary adenomas as followed: Neurological deficit: Chiasmal syndrome. Endocrinological signs: gigantism, dental malocclusion, prominent lips, nose, enlarged hands and feet (acromegaly), moon face, buffalo hump, mood swings, redistribution of fat, hirsutism (Cushing's Disease), galactorrhea, gynecomastea (prolactinoma), polydipsia (diabetes insipitus). We reviewed all fairytales from a medical perspective and matched the listed symptoms with the description of the characters. We then compared the description of specific individuals with illustrations by Ruth Koser-Michaels.
Results: We studied 106 fairytales in total and detected 7 fairytale individuals being described with clinical signs of acromegaly (4), Cushing's Disease (1), Diabetes insipidus (1) and chiasmal syndrome (1). All characters have been surprisingly illustrated with the classic signs of their ‘pituitary disease’.
Conclusion: We offer a potential insight to pituitary adenomas among fairytale characters. Some individuals were described with signs of neurological and endocrinological disorders possibly reflecting the prevalence of pituitary disease in the age of Brothers Grimm. Hormone-secreting adenomas such as Cushing's Disease or acromegaly are rare. People affected by these conditions in the early 18th century were possibly recognized by the population as monsters, trolls and outcasts as portrayed in Grimm's fairytales. With this study we want to raise awareness for patients with long duration of mal- or undiagnosed active disease in secreting pituitary adenomas.
