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

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.
鉴别诊断
- Addison's disease
- Primary hypothyroidism
- Shock (cardiogenic or septic)
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