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Hypopituitarism

Hypopituitarism is defined as a deficiency of one or more of the hormones produced by the pituitary gland. The causes of hypopituitarism can be attributed to either: a pathology of the hypothalamus affecting the production of trophic hormones that act on the pituitary Or direct pathology of the pituitary gland itself. The most common cause of hypopituitarism (61%) is the presence of pituitary tumors. Pituitary tumors may cause the increased production of one hormone with resultant deficiency of the other pituitary hormones as in acromegaly (excess GH with hypopituitarism from the macroadenoma). Secondary metastases originating from, for example, breast, colon, and prostate cancers do occur less commonly. Hypothalamic and para-pituitary tumors such as suprasellar meningiomas, gliomas, and craniopharyngiomas may also be associated with hypopituitarism. Other causes of hypopituitarism include injury to the pituitary gland following traumatic brain injury or iatrogenically during surgery or cranial irradiation. Inflammatory conditions of the pituitary may also be responsible for the occurrence of hypopituitarism. The infectious agents that can have been related to pituitary insufficiency include Mycobacterium tuberculosis and non-mycobacterial agents such as histoplasmosis, syphilis, viruses, and protozoa. Infiltrative diseases such as hemochromatosis, sarcoidosis, and histiocytosis may be associated with the development of hypopituitarism. Pituitary apoplexy is a medical emergency and is due to acute ischemic infarction or hemorrhage of the pituitary gland. Pituitary apoplexy may occur in the presence of a pituitary adenoma, but may also occur in the normal pituitary gland. Sheehan syndrome refers to infarction of the hyperplastic pituitary gland during pregnancy due to severe blood loss (post-partum hemorrhage). Because of the rich and complex vascular supply, pituitary adenomas have an increased risk of bleeding when compared to other brain tumors. Reference: Gounden V, Jialal I. Hypopituitarism. [Updated 2020 May 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NB... Image credit: Kjpargeter, Stockking / Freepik @ http://www.freepik.com https://pngtree.com/so/vector https://pngtree.com/so/direction https://en.wikipedia.org/wiki/File:18... https://www.toppr.com/ask/content/sto... https://www.clinicbarcelona.org/en/as... https://www.neurosurgicalatlas.com/vo...