Deficiency of one or more pituitary hormones.
Variable presentation depending on cause.
Symptoms include headaches, amenorrhea, galactorrhea, and visual field defects.
Treatment depends on correction of the underlying cause. Where causes are not correctable, treatment focuses on replacing the target hormones.
Patients who require cortisol for adrenocorticotropic hormone deficiency require increased dosage in times of stress (such as infection, trauma, and surgery).
Hypopituitarism refers to the partial or complete deficiency of one or more pituitary hormones. It may arise as a congenital defect during the development of the pituitary gland or as a result of acquired diseases of the pituitary gland, the parasellar structures, or the hypothalamus.
History and exam
- history of pituitary or hypothalamic disease
- history of traumatic brain injury
- failure to thrive or short stature
- delayed puberty
- family history of pituitary hormone deficiencies
- visual field defects
- cardiovascular events
- cold intolerance
- weight gain
- erectile dysfunction and reduced libido
- dry skin
- delayed relaxation of reflexes
- hypoactive sexual desire
- hot flashes
- nocturia and polyuria
- breast atrophy
- reduced bone and muscle mass
- loss of axillary and pubic hair
- serum electrolytes
- serum and urine osmolarity
- 8 a.m. cortisol and adrenocorticotropic hormone
- thyroid function tests
- 8 a.m. testosterone, follicle-stimulating hormone, and luteinizing hormone in men
- estradiol, follicle-stimulating hormone, and luteinizing hormone in women
- insulin-like growth factor-1
- cosyntropin/tetracosactide stimulation test
Bridget Sinnott, MD
Associate Professor of Medicine
Medical College of Georgia
BS declares that she has no competing interests.
Dr Bridget Sinnott would like to gratefully acknowledge Dr Vidhi Shah, the previous contributor to this monograph.
VS declares that she has no competing interests.
Amir Hamrahian, MD
Associate Program Director
Department of Endocrinology, Diabetes and Metabolism
AH declares that he has no competing interests.
Andrew James, BSc, MB BCh, MD, MRCP, FRCP
Newcastle Hospitals NHS Foundation Trust
Royal Victoria Infirmary
AJ declares that he has no competing interests.
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