Hypopituitarism -Quick review card

HYPOPITUITARISM Total or partial loss of pituitary gland function caused by pituitary or hypothalamic disorders

Adults - Most common cause is a pituitary adenoma , pituitary surgery or radiotherapy.

Primary - The problem is in the gland due to loss , damage or dysfunction of pituitary secreting cells tumours causing gland destruction ischaemia causing necrosis pituitary apoplexy ( tumour ) cavernous sinus thrombosis aneurysms of the intracranial carotid artery infection , infiltration , immunological primary empty Sella syndrome iatrogenic genetic

Secondary - Due to diseases of the hypothalamus or pituitary stalk which interrupts the nerve or vascular connection to the pituitary gland tumors infiltrative traumatic brain injury hormone induced iatrogenic infectious nutritional anorexia nervosa severe systemic illness genetic

Presentation - insidious onset often precipitated by a stressful event 75 % or more of the gland damage -is needed before HPP symptoms can be varied and depend upon the extent and severity of hormone deficiencies , duration of the disease and the age of onset large pituitary tumors may lead to pan hypopituitarism ie deficiency of cortisol , thyroxine , sex steroids and growth hormones and loss of visual field and acuity as the supresellar extension puts pressure on the optic...