Hypopituitarism may result from damage to the pituitary gland or hypothalamus. The most common cause in adults is pituitary tumors or adenomas. Other causes include intrasellar and parasellar tumors, inflammatory and infectious destruction, surgical removal, radiation-induced destruction of pituitary tissue, traumatic brain injury, subarachnoid hemorrhage, and postpartum pituitary necrosis (Sheehan syndrome). Similar diseases originating in the hypothalamus or pituitary stalk may also result in pituitary insufficiency.
Clinical signs and symptoms will depend on specific pituitary hormones affected. Onset is typically insidious and may go unrecognizable by the patient. Rarely, onset may be acute. Adrenocorticotropic hormone deficiency may cause cortisol insufficiency. Thyroid-stimulating hormone deficiency leads to hypothyroidism. Gonadotropin deficiency leads to hypogonadism. Child patients with growth hormone (GH) deficiency may have failure to thrive or short stature; adult patients with GH deficiency are mostly asymptomatic but may experience fatigue, weakness, and a decrease in life quality. Antidiuretic hormone deficiency presents with polyuria and polydipsia.
Patients are at increased risk for cardiovascular disease. Other complications of hypopituitarism include visual impairments and an increased susceptibility to infection.
Patients who are stable have a promising prognosis with replacement hormone therapy. However, patients with acute decompensation are in critical condition and may have a higher mortality rate.
Treatment is dependent on the cause but typically involves removal of tumor or replacement hormone therapy.
E23.0 – Hypopituitarism
74728003 – Hypopituitarism