Learn about the signs and symptoms, diagnosis and treatment options. Panhypopituitarism is a condition in which the production and secretion of all hormones by the pituitary gland is reduced. Graffeo CS, Link MJ, Brown PD, Young WF Jr., Pollock BE. Predictors of Hypopituitarism in Patients with Traumatic Brain Injury.
Giagulli VA, Castellana M, Perrone R, Guastamacchia E, Iacoviello M, Triggiani V. GH Supplementation Effects on Cardiovascular Risk in GH Deficient Adult Patients: A Systematic Review and Meta-analysis.
Quality of life in patients with hypopituitarism. The investigators found that in patients who received this lower dose, the rates of hypopituitarism at 2 and 5 years were 2% and 5%, respectively, compared with 31% and 51%, respectively, for those who received a mean dose of 11.0 Gy or higher.A study by Lee et al found that in patients with nonfunctioning pituitary adenomas, gross-total resection and/or adjuvant radiotherapy appear to prevent tumor recurrence or regrowth. Drugs
Some asymptomatic nonsecreting macroadenomas may have an option of close clinical/radiologic observation.
Prolactinomas, small and large, generally respond to medical therapy with tumor shrinkage and alleviation of mass symptoms. Dosage levels and the combination of medications may need to be adjusted over time.Sometimes repeat imaging tests or additional blood tests may be recommended. In pituitary apoplexy, prompt surgical decompression may be lifesaving if head imaging reveals clinically significant tumor mass effect. Glucocorticoids are required if the ACTH-adrenal axis is impaired. GH is not routinely replaced in adults unless the patient is symptomatic of GH deficiency, after all other pituitary hormones have been replaced.
Regal M, Paramo C, Sierra SM, Garcia-Mayor RV.
http://www.medscape.com/resource/hypogonadism
Of all the different causative conditions for adult hypopituitarism, pituitary adenoma and its treatment either by surgery or radiation therapy is found to be most frequently seen. Monitor the patient to avoid overreplacement.
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Li G, Shao P, Sun X, Wang Q, Zhang L. Magnetic resonance imaging and pituitary function in children with panhypopituitarism. Your doctor will go over the specific guidelines, such as when to double or triple your child's
Always consult your doctor for a diagnosis.Your doctor will usually ask a series of questions, including any symptoms you may have noticed, then assess your child’s growth and weight gain, and examine your child. Other hormone replacements are continued at their usual maintenance doses as appropriate.No special diet is necessary in patients with hypopituitarism unless dictated by an underlying disease process.
Medical care consists of hormone replacement as appropriate and treatment of the underlying cause. Abstract OBJECTIVE: To formulate clinical practice guidelines for hormonal replacement in hypopituitarism in adults. Hormone deficiency is treated by replacing the deficient hormones. The 2017 World Health Organization classification of tumors of the pituitary gland: a summary.
Fatemi N, Dusick JR, Mattozo C, et al. Radiation-induced hypopituitarism. Prevalence and incidence of hypopituitarism in an adult Caucasian population in northwestern Spain.
The goals of treatment are to improve symptoms (see Table 2) and to replace the deficient hormone or hormones at a level that is as close to physiologically correct (“mother nature”) as possible.
In men, testosterone replacement is used and substituted with human chorionic gonadotropin (hCG) injections if the patient desires fertility. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTIyMjg3LXRyZWF0bWVudA==
Hormone replacement therapy substitutes medically administered hormones for those normally produced by the pituitary gland. Diseases & Conditions
Silva PP, Bhatnagar S, Herman SD, Zafonte R, Klibanski A, Miller KK, et al.
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