Hypopituitarism
Keywords: Panhypopituitarism, Pituitary hormone deficiency
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Causes
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Appropriate Tests
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Diagnosis and evaluation may involve assay of pituitary or target gland hormones.
Dynamic stimulation tests may assist to evaluate hormone reserves - consult pathologist.
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Panhypopituitarism
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Patients may have clinical or radiological evidence of a space occupying lesion in the pituitary fossa.
They may present initially with deficiency of a single hormone: Prolactin, Testosterone (in males), Luteinising hormone, Follicle stimulating hormone (in post-menopausal females), Thyroid stimulating hormone, Free T4, Cortisol, Growth hormone.
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Non-functioning tumours
- Adenoma
- Craniopharyngioma
- Meningioma
- Germinoma
- Metastatic carcinoma
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Functioning tumours
- Prolactinoma
- Gonadotroph adenoma
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Alpha subunit - this may be the main secretory product of the tumour.
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Hypothalamic disorders
- Tumour
- Birth asphyxia
- Histiocytosis
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See also Pituitary/hypothalamic disorders
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Vascular disorders
- Post-partum necrosis (Sheehan's syndrome)
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Post-traumatic
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Post-hypophysectomy
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Post-irradiation
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Septo-optic dysplasia
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Granulomas
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Empty sella syndrome
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Genetic
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Single hormone deficiency
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May be the presenting feature of any cause of panhypopituitarism, however single hormone deficiency can occur and is usually genetic.
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Growth hormone
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Growth hormone stimulation test.
See Short stature
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IGF-1.
Growth hormone resistance, rather than deficiency; growth hormone levels are usually high.
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Thyroid stimulating hormone
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See also Hypothyroidism.
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Luteinising hormone, Follicle stimulating hormone
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See also Infertility (male and female) and Testicular failure. |
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ACTH
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See also Adrenocortical insufficiency.
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