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Hypopituitarism

Anup Sabharwal, MD MBA FACE FASPC FNLA Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Generalized condition caused by deficiency of anterior pituitary hormones: adrenocorticotropic hormone (ACTH), thyroid-stimulating hormone (TSH), luteinizing hormone (LH), follicle-s...

DIAGNOSIS

HISTORY

  • Initial symptoms are nonspecific, insidious, and dependent on severity of hormone deficiency: fatigue, hypotension, cold intolerance.

    • Pituitary failure secondary to tumors may present ...

TREATMENT

GENERAL MEASURES

If admitted for pituitary surgery, supplement with all deficient hormones, especially stress-dose glucocorticoids. 

MEDICATION

  • Adrenal insufficiency should be excluded before t...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • 1-, 3-, and 12-month evaluations for postsurgical or posttraumatic hormonal status and annual evaluation for those with hormone deficiencies (3...

REFERENCES

1
Schneider  HJ, Aimaretti  G, Kreitschmann-Andermahr  I, et al. Hypopituitarism. Lancet.  2007; 369(9571): 1461– 1470.  [View Abstract] ...

CODES

ICD10

  • E23.0 Hypopituitarism

  • E89.3 Postprocedural hypopituitarism

SNOMED

  • 74728003 Hypopituitarism (disorder)

  • 40781006 hypopituitarism due to pituitary tumor (disorder)

  • 14900002 Radiotherapy-induced hyp...

CLINICAL PEARLS

  • In patients with documented ACTH deficiency, emphasize the need for additional glucocorticoids at the time of any major physical stress or illness. The glucocorticoid dose can be doubl...

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