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Hypopituitarism, Pediatric

Craig A. Alter, MD and Shana E. McCormack, MD, MTR Reviewed 10/2018
 


BASICS

DESCRIPTION

Hypopituitarism refers to deficiencies of one or more pituitary hormones. 
  • “Panhypopituitarism” (pan meaning “all”) technically requires deficiency of all eight pituitary hormones; ho...

DIAGNOSIS

HISTORY

  • Birth history

    • Infants with hypopituitarism are usually normal or small for gestational age, in contrast to hyperinsulinemic infants, who are typically large for gestational age.

    • Documen...

TREATMENT

GENERAL MEASURES

Patients should have clear instructions available to first responders in case of emergency. 

MEDICATION

  • Hydrocortisone

    • Replacement doses if needed: 8 to 15 mg/m2/24 h PO, divide...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Initially, every 3 months by a pediatric endocrinologist

  • When pituitary hormones are replaced, expect the following:

    • ACTH deficiency: hydrocortisone (daily and stre...

ADDITIONAL READING

  • Ascoli P, Cavagnini F. Hypopituitarism. Pituitary.  2006;9(4):335–342. [View Abstract on OvidInsights]

  • Di Iorgi N, Napoli F, Allegri AE, et al. Diabetes insipidus—diagnosis and ...

CODES

ICD9

  • 253.2 Panhypopituitarism

  • 253.7 Iatrogenic pituitary disorders

ICD10

  • E23.0 Hypopituitarism

  • E89.3 Postprocedural hypopituitarism

SNOMED

  • 74728003 Hypopituitarism (disorder)

  • 40781006 hypopituitarism du...

FAQ

  • Q: When do I give stress doses of steroid and for how long?

  • A: Whenever the patient has fever, vomiting, serious illness, or surgery. Continue until 24 hours after stress resolves (e.g., the day af...

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