Causes of hypopituitarism

This is an automatically translated article.

The article was professionally consulted with Master, Doctor Vu Thi Duyen - Doctor of Nephrology - Endocrinology - Department of Examination & Internal Medicine, Vinmec Hai Phong International General Hospital.
Hypopituitarism is a condition in which the pituitary hormone is below normal. This is a condition in which the pituitary gland is impaired, leading to hormone deficiency and ultimately leading to failure of a variety of other endocrine glands such as adrenal insufficiency, hypothyroidism, hypogonadism, diabetes insipidus. etc...

1. What is hypopituitarism?

Hypopituitarism is a condition in which the pituitary gland is not working properly, reducing the amount of pituitary hormone produced and not meeting the body's needs. The pituitary gland located in the hypothalamus is a very important endocrine organ that directs the activities of other endocrine glands such as the thyroid and adrenal glands as well as the sex organs that produce hormones.
The pituitary gland has an important function of regulating metabolic processes in the body such as blood pressure, water, sexual function, stress. When hypopituitarism results in failure of other endocrine glands such as thyroid, adrenal glands and gonads not working properly, causing a variety of disorders in the body's activities.

2. Causes of hypopituitarism

Hypopituitarism is divided into 2 groups based on the cause: primary hypopituitarism due to pituitary gland and secondary hypopituitarism caused by hypothalamic disorders.
Causes of primary hypopituitarism:
Tumor: Massive tumor lesions such as pituitary adenoma, pituitary cyst, and metastatic cancer compress and reduce in size, leading to reduced pressure and deterioration function of the pituitary gland. Pituitary Infarction: Infarction of the pituitary gland due to Sheehan's syndrome occurs postpartum with hypopituitarism or vascular failure. Pituitary hemorrhage causes shock leading to pituitary collapse. Inflammatory processes, infections, abscesses: Meningitis caused by bacteria, tuberculosis, fungi, malaria, pituitary abscess, sarcoidosis, ... cause total hypopituitarism. Genes: Involved in translational factors and cell differentiation. Congenital hypopituitarism with pituitary gland disruption syndrome due to genetic mutations. Infiltrative disorders: Iron infection, Langerhans histiocytosis. Treatment: Immunosuppressive drugs cause hypopituitarism, surgery that often affects pituitary function, and radiation therapy after surgery. Autoimmune dysfunction: Lymphocytic pituitary inflammation is common in the postpartum period causing enlargement and destruction of the pituitary gland.

Causes of secondary hypopituitarism:
Tumor: Benign hypothalamic tumor, skull tumor, metastatic malignant tumor from lung, chest. Treatment: Radiation therapy for tumors affecting the hypothalamus by radiation leads to pituitary hormone disorders or secondary pituitary deficiency. Intrusive lesions: Inflammatory processes such as cellulitis, sarcoidosis, and Langerhan's cause deficiency and decrease in pituitary hormone. Infections: Meningitis caused by tuberculosis, viruses, candida, immunodeficiency such as HIV, ... Brain trauma: Traumatic brain injury damages the skull base causing pituitary hormone deficiency.

3. Clinical symptoms of hypopituitarism

Clinical manifestations of hypopituitarism are diverse and are symptoms of other endocrine insufficiency such as thyroid, adrenal, and gonads.
Fatigue, anorexia, muscle weakness, loss of appetite, vomiting, nausea, low blood pressure, decreased skin pigmentation. This is a manifestation of adrenal insufficiency, severe can cause high fever, hypoglycemia, pulse collapse, coma. Yellow dry skin, dry and brittle hair, sluggishness, sluggishness, low blood pressure, slow heart beat, hoarse voice, digestive disorders, constipation, these are manifestations of hypothyroidism. Hormonal disorders caused by hypopituitarism affect pubertal development such as testicles, small penis, thin skin, many wrinkles, decreased muscle mass, loss of beard, osteoporosis, sex drive reduction, impotence, male infertility (in men); delayed puberty, mammary gland failure, amenorrhea, female infertility, hair loss in the armpits and genitals, osteoporosis (in women). Lack of prolactin hormone in postpartum women reduces or does not produce milk, atrophy of the mammary glands, ... Deficiency of growth hormone GH due to hypopituitarism causes delayed teething, growth retardation, delayed puberty in children, ability to write poor memory and concentration, frequent low blood sugar and high risk of cardiovascular disease.

The whole body can manifest from weight loss, emaciation, sluggishness, forgetfulness to loss of reactions and severe hallucinations such as schizophrenia. Depending on the cause of the decrease in pituitary hormone, there will be different symptoms such as loss of smell, nerve paralysis, ... due to pituitary tumor; hyperthyroidism, Cushing's syndrome, dipole enlargement, decrease or loss of lactation, ... due to hormone-secreting pituitary tumor; skin tanning caused by Wilson, ...

4. Diagnosis and treatment of hypopituitarism

Diagnosis of hypopituitarism is based on:
Examination with clinical symptoms as above. Blood and urine tests to measure pituitary hormones. An MRI of the pituitary gland to check and evaluate the pituitary gland during hormone replacement therapy. Treatment of hypopituitarism is mainly based on the cause of the disease, including the following methods:
Taking hormone replacement drugs. Surgery is indicated in cases where tissue near the brain affects the pituitary gland or the pituitary gland is not developing normally.

There are many causes of hypopituitarism, which is divided into 2 main types that directly affect the pituitary gland and caused by the hypothalamus. Therefore, to avoid affecting your health, when you have signs of hypopituitarism, you should go to medical facilities for a health examination, early detect the medical condition for timely and effective treatment. .
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