Panhypopituitarism
Background
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Deficiency of anterior pituitary hormones
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ACTH → cortisol deficiency (2° adrenal insufficiency)
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Tx w/ Hydrocortisone (note: mineralocorticoid replacement not necessary)
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TSH → hypothyroidism
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Gonadotropins (LH/FSH) → anovulation, perimenopausal symptoms in females, testicular hypofunction in males
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Growth hormone (GH) → short stature in children, Δ in body composition in adults
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Prolactin → inability to lactate
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Causes:
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Hypothalamus: tumors (ex craniopharyngiomas), RTX, infiltrative lesions (ex sarcoidosis), infxn (ex meningitis), TBI, stroke (ischemic, hemorrhagic)
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can also lead to ↓ vasopressin --> diabetes insipidus
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Pituitary gland: mass lesion (ex pituitary adenoma), pituitary surgery, pituitary infarction (ex Sheehan syndrome after postpartum hemorrhage), RTX, pituitary apoplexy (sudden hemorrhage into pituitary gland), congenital dz, hypophysitis, hemochromatosis
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Considerations
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Adrenocortical insufficiency can be life-threatening w/ complete vascular collapse → tx w/ IV hydrocortisone, IV fluids, +/- glucose
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Need for stress dose steroids
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Hypothyroidism
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May present for Pituitary Surgery
References
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Gounden V, Anastasopoulou C, Jialal I. Hypopituitarism. [Updated 2022 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470414/