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Hypopituitarism

最后审阅: 13 Feb 2025
最后更新: 26 Jan 2022

小结

定义

病史和体格检查

关键诊断因素

  • presence of risk factors
  • headaches
  • faltering growth or short stature
  • infertility
  • hypoglycaemia
  • amenorrhoea/oligomenorrhoea
  • galactorrhoea
  • delayed puberty
  • family history of pituitary hormone deficiencies
  • hypotension
  • visual field defects
  • ophthalmoplegia
完整详情

其他诊断因素

  • cardiovascular events
  • cold intolerance
  • weight gain
  • erectile dysfunction and reduced libido
  • nausea
  • vomiting
  • fatigue
  • weakness
  • dizziness
  • constipation
  • dry skin
  • delayed relaxation of reflexes
  • hypoactive sexual desire
  • hot flushes
  • nocturia and polyuria
  • breast atrophy
  • reduced bone and muscle mass
  • loss of axillary and pubic hair
完整详情

危险因素

  • pituitary tumour
  • pituitary apoplexy
  • pituitary surgery
  • cranial radiation
  • traumatic brain injury
  • genetic defects
  • inflammatory disorders
  • hypothalamic disease
  • severe postpartum haemorrhage (Sheehan syndrome)
  • empty sella syndrome
  • tuberculous meningitis
  • syphilis
完整详情

诊断性检查

首要检查

  • serum electrolytes
  • serum and urine osmolarity
  • 8 a.m. cortisol and adrenocorticotrophic hormone
  • thyroid function tests
  • 8 a.m. testosterone, follicle-stimulating hormone, and luteinising hormone in men
  • estradiol, follicle-stimulating hormone, and luteinising hormone in women
  • prolactin
  • insulin-like growth factor-1
  • cosyntropin/tetracosactide stimulation test
完整详情

需考虑的检查

  • insulin tolerance test
  • water deprivation and desmopressin response test
  • MRI pituitary
  • CT pituitary
  • metyrapone testing of the adrenal axis
完整详情

治疗流程

初步治疗

pituitary apoplexy

持续性治疗

hypopituitarism

撰稿人

作者

Bridget Sinnott, MD
Bridget Sinnott

Professor of Medicine

Medical College of Georgia

Augusta

GA

利益声明

BS declares that she has no competing interests.

鸣谢

Dr Bridget Sinnott would like to gratefully acknowledge Dr Vidhi Shah, the previous contributor to this topic.

利益声明

VS declares that she has no competing interests.

同行评议者

Amir Hamrahian, MD

Associate Program Director

Department of Endocrinology, Diabetes and Metabolism

Cleveland Clinic

Cleveland

OH

利益声明

AH declares that he has no competing interests.

Andrew James, BSc, MB BCh, MD, MRCP, FRCP

Consultant Endocrinologist

Newcastle Hospitals NHS Foundation Trust

Royal Victoria Infirmary

Newcastle

UK

利益声明

AJ declares that he has no competing interests.

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