Panhypopituitarism
Definition
The pituitary gland is in the brain. It produces important hormones. In hypopituitarism the gland does not produce enough hormones. In panhypopituitarism the gland does not produce any hormones. The pituitary gland shuts down. It is most noticeable in children. Their growth is stunted. Dwarfism can occur.
Pituitary Gland
Causes
This condition is most often caused by damage to the gland.
In children, damage to the pituitary gland may be caused by:
Risk Factors
The following factors increase your chance of developing panhypopituitarism:
- Receiving damage to the pituitary gland (eg, trauma, radiation, cancer spread, postpartum hemorrhage)
- Having a tumor on the pituitary gland
Symptoms
Symptoms arise from:
Compression From Tumor
- Blurred vision
- Loss of visual field
- Poor temperature control
Insufficient Hormones
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Insufficient levels of gonadotropins
- In premenopausal women causes: missing menstrual cycles, infertility, osteoporosis, vaginal dryness, as well as loss or reduction in female characteristics
- In men causes: impotence, reduced size of testes, decreased production of sperm, infertility, breast enlargement, reduced muscle mass, and loss or reduction in male characteristics (eg, beard growth)
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Insufficient levels of growth hormone
- In children causes: stunted growth or dwarfism
- In adults causes: weakness, obesity, reduced cardiac output, low blood sugar levels, and reduced exercise tolerance
-
Insufficient levels of thyroid-stimulating hormones
- Leads to underactive thyroid, which causes confusion, hair loss, weakness, slow heart rate, muscle stiffness, intolerance to cold, constipation, weight gain, and dry skin
-
Insufficient corticotrophic levels
- Leads to underactive adrenal gland: causes low blood pressure, low blood sugar, fatigue, weight loss, vomiting, and low stress tolerance
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Excessive prolactin levels
- Causes women to have missed periods, infertility, and milk secretion
- Men causes: reduced facial and body hair and small testes
Diagnosis
Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests may include the following:
- MRI scan —a test that uses magnetic waves to make pictures of structures inside the body
- Blood tests—to measure hormone levels
- Stimulation tests—to test the reserve of the endocrine glands, especially the pituitary gland
- Semen analysis—in males suspected of infertility
Treatment
Talk with your doctor about the best plan for you. Treatment depends on the cause of the condition. The goal of treatment is to restore normal hormone production of the pituitary gland.
Treatment options include:
- Hormone replacement therapy—based on what types of hormones are missing
- Tumor removal—done if the cause of the damage is a tumor
- Radiation therapy —done if the cause of the damage is a cancer or tumor
Prevention
The majority of causes are not preventable. Injury prevention can prevent some cases.
Resources:
The Endocrine Society
The Hormone Foundation
The Pituitary network
Canadian Resources:
About Kids Health
Health Canada
References:
Diabetes & other endocrine and metabolic disorders: hypopituitarism. Lucile Packard Children's Hospital website. Available at: http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/...betes/hypop.html. Accessed May 30, 2007.
Geffner M. Panhypopituitarism. The Magic Foundation website. Available at: http://64.233.167.104/search?q=cache:MHUYAhcYci8J:https://www.magicfoundation.org/downloads/PanPitpdf669.pdf+Panhypopituitarism&hl=en...=clnk&cd=8&gl=us. Accessed May 30, 2007.
Schneider HJ, Aimaretti G, Kreitschmann-Andermahr I, et al. Hypopituitarism. Lancet. 2007;269:1461-1470.
Toogood AA, Stewart PM. Hypopituitarism: clinical features, diagnosis, and management. Endocrinol Metab Clin North Am. 1998;37:235-261
What is a growth disorder? KidsHealth: Medical Problems: Endocrine Glands, Growth, & Diabetes. The Nemours Foundation website. Available at: http://kidshealth.org/parent/medical/endocrine/g...th_disorder.html. Accessed May 30, 2007.
Last reviewed January 2009 by Rosalyn Carson-DeWitt, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.