Hypopituitarism
What is it?
Hypopituitarism is a rare disorder involving underproduction of hormones by the pituitary gland. The pituitary, deep in the brain, is the most important gland in the body's endocrine, or hormonal, system. One of the six hormones produced by the anterior portion of the pituitary is human growth hormone (HGH). In children, HGH deficiency may lead to impaired growth, or dwarfism. Early diagnosis and administration of HGH can correct this hormonal deficiency and result in normal or near-normal height. Deficiencies in other pituitary hormones produce a wide variety of symptoms; in panhypopituitarism, deficiencies occur in all pituitary hormones. Because pituitary hormones stimulate hormone production in other glands, hypopituitarism may have a snowball effect, resulting in deficiencies of adrenal, thyroid, and sex hormones (see Diabetes Insipidus, Addison's Disease, and Hypothyroidism for more information).
What Causes It?
- A tumor located in or near the pituitary gland is the most common cause of hypopituitarism.
- Pituitary surgery or radiation is a potential cause.
- Hypopituitarism may develop in the postpartum period (Sheehan's syndrome) because of necrosis (tissue death) in the pituitary as it outgrows its blood supply during pregnancy.
- Inflammatory processes such as those that occur with tuberculosis are a possible cause.
- Infiltration of the pituitary by a starchy protein (amyloidosis) or iron (hemochromatosis) may result in hypopituitarism.
Prevention
- There is no way to prevent hypopituitarism.
Diagnosis
- Patient history and physical examination.
- Blood tests to measure levels of pituitary, gonadal, thyroid, and adrenal hormones.
- X-rays, MRI (magnetic resonance imaging), or CT (computed tomography) scans to detect a tumor.
How to Treat It
- Lifelong hormonal replacement therapy is necessary. The specific hormones needed will depend on the nature of the deficiency. To treat adult panhypopituitarism, it is necessary to replace thyroid, adrenal, and gonadal hormones.
- HGH replacement therapy is necessary for children and adolescents to obtain normal growth. HGH is also recommended for adults to maintain normal metabolism.
- In some cases, doses of corticosteroids (such as hydrocortisone or prednisone) must be increased during periods of stress, illness, infection, or surgery.
- It may be necessary to reduce insulin dosage in people with diabetes who develop hypopituitarism.
- If a tumor causes hypopituitarism, surgery or radiation therapy may be warranted.
When to Call a Doctor
- Call a doctor if you or your child develop any of the symptoms of hypopituitarism.
- EMERGENCY Nausea, vomiting, extreme weakness, dehydration, and fever suggest adrenal insufficiency that may require emergency medical care.
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Copyright © 2008 Medletter Associates, LLC
Content excerpted from Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference.