Pituitary Disease - Hypopituitarism

Question 1

What is Hypopituitarism?

Answer 1

Inadequate production of one or more of the hormones secreted by the pituitary gland.

Question 2

What is Panhypopituitarism?

Answer 2

Deficiency of all hormones - commonly caused by surgery/radiotherapy.

Question 3

Aetiology of Hypopituitarism (7).

Answer 3

1. Compression of Pituitary Gland - Non-Secretory Pituitary Macroadenoma (commonest).
2. Pituitary Apoplexy.
3. Sheehan’s Syndrome (postpartum Pituitary Necrosis following haemorrhage).
4. Hypothalamic Tumours e.g. Craniopharyngoma.
5. Trauma.
6. Iatrogenic Irradiation.
7. Infiltrative Disease e.g. Haemochromatosis, Sarcoidosis.

Question 4

Clinical Features of Low Hormones (6).

Answer 4

1. Low ACTH - Tiredness, Postural Hypotension.
2. Low FSH/LH - Amenorrhoea, Infertility, Loss of Libido.
3. Low TSH - Cold, Constipation.
4. Low GH - Short Stature.
5. Prolactin - Lactation Problems.

Question 5

Symptoms Suggestive of Underlying Cause.

Answer 5

1. Bitemporal Hemianopia - Pituitary Macroadenoma.

2. Sudden Severe Headache - Pituitary Apoplexy.

Question 6

Investigations of Hypopituitarism.

Answer 6

1. Hormone Profile Testing.

2. Imaging.

Question 7

Management of Hypopituitarism.

Answer 7

1. Treatment of Underlying Cause.

2. Replacement of Deficient Hormones.