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Hypopituitarism

Anup K. Sabharwal, MD, MBA, FACE and Atil Y. Kargi, MD Reviewed 06/2018
 


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 and insidious, depending on severity of hormone deficiency: fatigue, hypotension, cold intolerance.

    • Pituitary failure secondary to tumors may present w...

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 on OvidMedline]
2
Fernandez-Rodriguez E, Bernabeu I, Castr...

CODES

ICD10

  • E23.0 Hypopituitarism

  • E89.3 Postprocedural hypopituitarism

ICD9

  • 253.2 Panhypopituitarism

  • 253.7 Iatrogenic pituitary disorders

SNOMED

  • 74728003 Hypopituitarism (disorder)

  • 40781006 hypopituitarism du...

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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