Hypopituitarism

E23.0

• Description
• Diagnostic criteria
• Medicine treatment
• Referral

DESCRIPTION

Multiple or isolated deficiencies of adrenocorticoid hormone (ACTH), luteinising hormone, thyroid stimulating hormone, prolactin and growth hormone manifesting as hypoglycaemia, abnormal body proportions and failure to grow and develop. If the posterior pituitary is involved (ADH deficiency), then this condition is known as panhypopituitarism.

The deficiency may be due to:

• congenital abnormalities with/without midline structural abnormalities of the brain,
• central nervous system tumours,
• histiocytosis,
• complications of radiation therapy.

DIAGNOSTIC CRITERIA

Clinical

• Neonates with hypopituitarism may present with:
  • persistent hypoglycaemia,
  • cholestatic jaundice (related to low cortisol),
  • micropenis.
• Growth failure with immature body proportions.
• Polydipsia, polyuria, nocturia in the case of panhypopituitarism.

Investigations

• Endocrine evaluation with pituitary function tests under specialist supervision.
• Confirm diagnosis in older children with stimulation tests.

MEDICINE TREATMENT

To correct hypoglycaemia:

• Hydrocortisone, IV, 2-3 mg/kg.

REFERRAL

• All patients after stabilisation of hypoglycaemia.