Hypopituitarism history and symptoms
Hypopituitarism history and symptoms On the Web
American Roentgen Ray Society Images of Hypopituitarism history and symptoms
A positive history of head trauma, adenoma, a lesion such as a sellar lesion, or any symptom related to pituitary hormonal deficiency is suggestive of hypopituitarism. Patients of hypopituitarism may be asymptomatic or show symptoms which can be nonspecific or specific for the deficient hormone. Patients with acute onset of hypopituitarism can present with a headache, nausea, vomiting, visual impairment, fatigue, cold intolerance, hypotension, and dizziness. Patients with chronic hypopituitarism can present with pallor, weight loss, and anorexia.
Past medical history
- A positive history of head trauma, adenoma, a lesion such as a sellar lesion, or any symptom related to pituitary hormonal deficiency is suggestive of hypopituitarism.
- The Growth Hormone Research Society recommends the consideration of diagnosis of growth hormone (GH) deficiency only in those patients who have a positive history of any pituitary disease or damage secondary to trauma, surgery, radiation, tumor, and previous history of growth hormone therapy because some factors such as obesity and age can affect the results of dynamic tests and may lead to inappropriate diagnosis
Clinical presentation in hypopituitarism depends upon following factors:
(a) The onset
- Acute: Sudden onset of symptoms as seen in pituitary apoplexy.
- Chronic: Slow onset, may take years to manifest such as radiation damage.
(b) The severity of hormonal deficiency
- Complete hormonal deficiency: May present even in normal circumstances.
- Partial hormonal deficiency: May present only in times of stress.
(c) The number of deficient hormones
Patients of hypopituitarism may be asymptomatic or show symptoms which can be nonspecific or specific for the deficient hormone such as an adrenal crisis or profound hypothyroidism. Patients can also present with symptoms suggestive of a mass lesion. Metastasis usually involves posterior pituitary initially thus presenting as diabetes insipidus. Patients with a sellar mass may present with a headache, diplopia, or visual loss.
|Acute hypopituitarism (several hours to a few days)||Chronic hypopituitarism (week to months/years)|
Symptoms of deficient hormones
In hypopituitarism, either one of the pituitary gland hormones may be deficient or all hormones may be deficient (depending upon the extent of pituitary gland involvement- complete or partial). The following table enlists the symptoms associated with each hormonal deficiency:
|Pituitary gland||Hormone||Symptoms of deficiency|
|Anterior pituitary||Adrenocorticotrophic Hormone (ACTH)||The most critical hormonal deficiency associated with hypopituitarism.|
|Growth Hormone (GH)|
|Gonadotropin hormones:||In men:
|Thyroid Stimulating Hormone (TSH)|
|Anti Diuretic Hormone (ADH)|
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