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Hypopituitarism.

Claire E Higham1, Gudmundur Johannsson2, Stephen M Shalet1

  • 1Department of Endocrinology, Christie Hospital NHS Foundation Trust, Manchester, UK; Centre for Endocrinology and Diabetes, Institute of Human Development, Faculty of Medical and Human Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.

Lancet (London, England)
|April 5, 2016
PubMed
Summary
This summary is machine-generated.

Hypopituitarism, a deficiency in pituitary hormones, increases mortality risk, especially from cortisol deficiency. Prompt diagnosis and hormone replacement therapy are crucial for managing this condition.

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Area of Science:

  • Endocrinology
  • Internal Medicine

Background:

  • Hypopituitarism involves deficiency of one or more pituitary hormones.
  • Cortisol deficiency due to adrenocorticotropic hormone (ACTH) deficiency is a major risk factor for excess mortality in hypopituitarism.
  • Pituitary adenomas, surgery, and radiotherapy are common causes in adults.

Purpose of the Study:

  • To provide a comprehensive overview of hypopituitarism.
  • To outline diagnostic approaches and management strategies.
  • To highlight critical aspects of hormone replacement therapy.

Main Methods:

  • Diagnosis involves baseline blood sampling for certain hormone deficiencies.
  • Dynamic stimulation tests are typically required for assessing ACTH, growth hormone, and antidiuretic hormone deficiencies.
  • Regular reassessment of pituitary function is necessary for slowly evolving forms.

Main Results:

  • Replacement therapies include thyroxine, hydrocortisone, sex steroids, growth hormone, and desmopressin.
  • In acute onset, cortisol deficiency replacement is prioritized.
  • Treatment requires modification during pediatric to adult transition and pregnancy.

Conclusions:

  • Effective management of hypopituitarism relies on accurate diagnosis and timely hormone replacement.
  • Close monitoring and tailored treatment adjustments are essential for optimal patient outcomes.
  • Understanding the diverse causes and management nuances is key for clinicians.