Anterior hypopituitarism

E23.0-3/E28.3/E29.1


DESCRIPTION

Absent or diminished secretion of one or more anterior pituitary hormones due to primary damage of the anterior pituitary gland, or secondary to hypothalamic dysfunction, which may result in hypothyroidism and/or hypoadrenalism and/or hypogonadism or growth retardation in children.

GENERAL MEASURES

Surgery is required for large tumours, pituitary apoplexy, and hormone secreting tumours (except for most patients with prolactinomas, who generally respond well to medical therapy).

Radiotherapy may be required in selected patients.

A notification bracelet is needed.

MEDICINE TREATMENT

Acute crisis

Treat as for acute crisis in Adrenal Insufficiency (Addison’s Disease).

Chronic

See Adrenal Insufficiency (Addison’s Disease).

Hypoadrenalism

See Adrenal Insufficiency (Addison’s disease) and Hypothyroidism.

Hypothyroidism

See Hypothyroidism.

Hypogonadism

Individualise dosage and need for replacement according to age, symptoms, etc.

Women:

As for postmenopausal HT, see Menopause and perimenopausal syndrome.

Men:

  • Testosterone cypionate, IM, 200–300 mg every 3–4 weeks.

See Androgen deficiency.

REFERRAL

All diagnosed patients for initial assessment.