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The response to stress—be it physical or psychological, acute or chronic—involves activation of the Hypothalamic-Pituitary-Adrenal (HPA) axis. The HPA axis is part of the neuroendocrine system because it involves both neuronal and hormonal communication. Its function is to regulate homeostatic systems—metabolic, cardiovascular, and immune—providing the necessary means to respond to a stressor.
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The small, pea-sized pituitary gland is located at the base of the brain. It is crucial in regulating various bodily functions, from growth to reproduction. The gland is divided into the anterior lobe and the posterior lobe. The secretory cell clusters in the pars distalis of the anterior pituitary lobe are controlled by hypothalamic regulators and synthesize six primary hormones.
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Development of Organoids from Mouse Pituitary as In Vitro Model to Explore Pituitary Stem Cell Biology
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[Opioid Induced Pituitary Dysfunction].

Asta Isfold Jonasdottir1, Jakob Johannsson2, Mar Kristjansson2

  • 1Department of Endocrinology.

Laeknabladid
|July 5, 2018
PubMed
Summary

Opioid therapy can cause serious pituitary dysfunction, leading to low hormone levels and decreased breathing. Glucocorticoid replacement therapy effectively treated this opioid side effect in a patient with cancer.

Keywords:
Opioiddeficiencyendocrine dysfunctionendocrinologyendocrinopathyhypopituitarismpain

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Area of Science:

  • Endocrinology
  • Oncology
  • Pharmacology

Background:

  • A 77-year-old female patient with a history of anal squamous cell carcinoma presented with malaise, nausea, diarrhea, and back pain.
  • The patient's condition was managed with opioid therapy for pain associated with a vertebral compression fracture.

Observation:

  • Following initiation of opioid therapy, the patient developed progressive hypotension, hyponatremia, and decreased respiratory drive.
  • Laboratory results revealed decreased serum cortisol, TSH, and LH levels, with a slightly elevated prolactin level.

Findings:

  • A Synacthen test and brain MRI were normal, ruling out other causes of pituitary dysfunction.
  • The clinical presentation and hormonal profile suggested opioid-induced pituitary dysfunction.

Implications:

  • Opioid-induced pituitary dysfunction is a serious, underrecognized side effect of opioid analgesics.
  • Prompt diagnosis and glucocorticoid replacement therapy can effectively manage this condition, improving patient outcomes.