Hypopituitarism Flashcards
Diminished or absent secretion of one or more pituitary hormones
Hypopituitarism
Potential causes of Hypopituitarism in children
Can be either Hypothalamic or Pituitary
- Tumors (Adenomas, Craniopharyngiomas, metastases)
- Trauma (brain injury, MVC, radiation, surgery)
- Infiltration (TB, sarcoid, lymphoma)
- Genetic mutations* (prop-1 or pit-1)
- Idiopathic *
- more common in children
What pituitary hormone deficiencies are used to diagnose pituitary deficits in CHILDREN?
- GH
- Prolactin
- ADH
Signs/Symptoms of GH deficiency in CHILDREN
- Short stature
- Cherubic face (Prominent forehead & maxillary hypoplasia)
- Delayed dentition (central incisor)
- Delayed puberty
- Truncal obesity
- Microphallus (small penis)
- Delayed bone age on x-ray (by at least 2 yrs)
Steps in diagnosing GH deficiency (in both adults and children)
- Screening by measuring IGF-1/GH
- Confirmation by GH stimulation test
- Measure GH after administration of stimulus
Stimuli used to induce GH stimulation
- Insulin (hypoglycemia)
- CNS neuroactive agents (arginine, clonidine, glucagon)
- GHRH
Treatment of GH deficiency in children
recombinant human GH (rhGH)
Treatment of FSH/LH deficiency in children
- Goal: puberty induction
Females: estrogen first, then progesterone
Males: testosterone
Treatment of TSH deficiency in children
Levothyroxine
Treatment of ACTH deficiency in children
Hydrocortisone, prednisone, or dexamethaxasone
- may need to increase with illness/stress
What two treatments are necessary for growth/maturation in children with pituitary deficits?
- recombinant human GH
2. Levothyroxine
What genetic mutation is associated with pituitary dwarfism (therefore hypopituitarism) and hypothyroidism?
Pit-1 mutation
Tumor that occurs along pituitary stalk in suprasellar region; associated with panhypopituitarism
craniopharyngioma
Potential causes of Hypopituitarism in adults
Can be either Hypothalamic or Pituitary
- ** Tumors (Adenomas, Craniopharyngiomas, metastases)
- ** ischemic necrosis (apoplexy/sheehan’s)
- Trauma (brain injury, MVC, radiation, surgery)
- Infiltration (TB, sarcoid, lymphoma)
- Genetic mutations* (prop-1 or pit-1)
** more common in adults
1 cause of Hypopituitarism in ADULTS
Tumors (non-functioning)
75% of Non-functioning Pituitary Tumors secrete what?
alpha-subunit of pituitary glycoprotein hormones, which has no biologic activity
Signs/Symptoms of GH deficiency in ADULTS
- Inc. adipose
2. Reduced strength/muscle mass
Signs of FSH/LH deficiency in ADULTS
Women:
- oligo/amenorrhea
- vaginal dryness, hot flashes
- Loss of pubic/axillary hair
Men:
- loss of libido and ED
- Loss of pubic/axillary hair
Signs of TSH deficiency (similar to hypothyroidism) in ADULTS
Fatigue Cold intolerance Constipation Dry skin Hair loss
Signs of ACTH deficiency in ADULTS (similar to adrenal insufficiency)
Fatigue
Anorexia/Weight loss
Orthostatic hypotension
Signs of prolactin deficiency in ADULTS
*usually in postpartum females
inability to lactate
(darker/lighter) skin complexion is associated with panhypopituitarism
lighter
Treatments for FSH/LH deficiency in ADULTS
Women:
- Estrogen/Progestin pills/patches
- LH/FSH injections for fertility
Men:
- Testosterone gel,patch, etc.
- LH/FSH injections for fertility
Treatment for TSH deficiency in ADULTS
Levothyroxine
