Post Contents List
PRESENTATIONS OF HYPOPITUITARISM
This depends on the hormones which are deficient. GH deficiency causesApproach to Chest Pain Differential diagnosis of chest pain. Read more ... » growth disorder and abnormal body structure.
Gonadotrophin deficiency causes infertility, menstrual and sexual dysfunction and loss of secondary sexual characteristics in men.
TSH and ACTH deficiency cause growth retardation, hypothyroidismThyroid Disorders Examination and Laboratory tests. Read more ... », adrenalAldosteronism Clinical features Causes and Treatment. Read more ... » insufficiency. Mineralocorticoid action is retained.
PRL(prolactin) deficiency causes failure of lactation.
If Posterior pituitary is also involved there is polyuria, polyd’Rsia due to vasopressin deficiency.
Lab investigations for Hypopituitarism
- There are low levels of trophic hormones and low level of target hormones also e.g. Iow ACTHACTH and TSH DEFICIENCY Diagnosis with Treatment. Read more ... » with low cortisol, low FSH with low testosterone, estradiol, progesterone, low level of TSHACTH and TSH DEFICIENCY Diagnosis with Treatment. Read more ... » with low T31 T4, low levels of GH with low IGF (insulinHyperglycemic Hyperosmolar State (HHS) Acute Complication Of DM. Read more ... » like growth factors).
- Provocative tests are done to assess pituitaryAldosteronism Clinical features Causes and Treatment. Read more ... » reserve.
Hypopituitarism Risk Factors
- Infiltrative diseases
- Lymphocytic hypophysitis
- Pregnancy and delivery
- Vascular aneurysms
Assessment history of pituitary function,
- Pregnancy-related hemorrhage or hypotensionHyperglycemic Hyperosmolar State (HHS) Acute Complication Of DM. Read more ... »
- Gonadal dysfunction
- Empty sella
- Craniofacial abnormalities
- Pituitary or hypothalamicHypothalamic, Pituitary And Other Sellar Masses. Read more ... » lesions
- Inflammatory or granulomatous diseaseApproach to Chest Pain Differential diagnosis of chest pain. Read more ... »
- Head trauma or head surgery
- Cranial radiation
Hypopituitarism Physical Exam
- •Pituitary failure secondary to tumors:
- ACTH: Hypotension, anorexia, pallor, weight loss
- Gonadotropins: Delayed puberty
- TSH: Weight gain, hair loss, dry skin, bradycardiaSINUS Bradycardia Bradyarrhythmia Symptoms Causes Diagnosis with Treatment. Read more ... », hoarseness, hypotension
- GH: Decreased muscle mass and strength, increased visceral fat, growth retardation
- •Visual field defects
- Congenital malformations and syndromes, especially malformations of the head and genitalia
- Growth retardation and delayed puberty
Hypopituitarism Differential Diagnosis
- Primary hypothyroidism
- Primary hypogonadism
- Kallmann syndromeMetabolic,Insulin Resistance Syndrome X Causes Symptoms. Read more ... »
- Hypothalamic insufficiency
- Constitutional short stature
- ChronicChronic Hepatitis Classification viral hepatitis Clinical features and Treatment. Read more ... » liver disease
- Addison disease, primary adrenal insufficiency
Treatment of Hypopituitarism
- Generalized condition caused by partial or total failure of anterior pituitary gland’s hormones: adrenocorticotropic hormoneAnterior Pituitary Hormones and Disorders. Read more ... » (ACTH), thyroidThyrotoxic crisis or Thyroid storm. Read more ... »-stimulating hormone (TSH), luteinizing hormone (LH), follicle-stimulating hormone (FSH), growth hormone (GH), and prolactin.
- Less commonly, the posterior pituitary gland’s hormones can be affected: AVPSIADH or Syndrome of inappropriate ADH (AVP). Read more ... »/ADH and oxytocin.
- Hormone replacement therapy like glucocorticoids, thyroid hormone, sex steroids, growth hormone, vasopressin are given.
- Shortages of ACTH, TSH, and ADH can be life-threatening.
- Synonym(s): Empty sella syndrome; Hypopituitarism; Pituitary cachexia; Simmonds syndrome; Panhypopituitarism; as a consequence of blood loss during pregnancy, Sheehan syndrome
- SystemApproach to Chest Pain Differential diagnosis of chest pain. Read more ... »(s) affected: Cardiovascular; EndocrineAldosteronism Clinical features Causes and Treatment. Read more ... »/Metabolic; GI; Musculoskeletal; Nervous; Reproductive; Skin/Exocrine
- Treatment of ACTH, TSH, LH, and FSH deficiencies similar to the treatment of primary hormone deficiencies of their respective target organ:
- ACTH deficiencyACTH and TSH DEFICIENCY Diagnosis with Treatment. Read more ... » results in cortisol deficiency:
- Treatment consists of administration of glucocorticoid hormones (hydrocortisone, dexamethasone, or prednisone) to mimic normal pattern of cortisol secretion; mineralocorticoid replacement is rarely necessary.
- Dosages and administration schedule vary according to age and sex.
- Hypoprolactinemia has no treatment.
- LH and FSH deficiency: Treatment depends on gender and whether fertility is desired.
- Men: Testerone replacement if fertility not desired; gonadotropins for fertility
- Recombinant human GH (for treating short stature in children and for treating selected adult patients)
- TSH deficiencyACTH and TSH DEFICIENCY Diagnosis with Treatment. Read more ... »: Goal of treatment is normal free T4 value. Treat with levothyroxine.
- Women: Estrogen–progesterone (and possibly testosterone) replacement, or pulsatile gonadotropins for fertility
- Infectious disease: Antibiotics as appropriate
- Inflammatory or granulomatous disease: Specific treatment
- Adrenal insufficiency should be excluded before thyroid hormone replacement is initiated; otherwise, thyroid hormone replacement could precipitate adrenal crisis
- Replacement of hormones secreted by target glands