aetiology
Last reviewed 01/2018
The aetiology of hypopituitarism includes:- neoplasms in the suprasellar region:
- pituitary adenoma in adults
- craniopharyngioma in children
- glioma
- meningioma
- metastatic cancer
- infiltration:
- sarcoid
- histiocytosis X
- haemochromatosis
- infection:
- tuberculous meningitis
- syphilis
- encephalitis
- vascular:
- Sheehan's syndrome (post-partum infarction)
- pituitary apoplexy
- carotid artery aneurysms
- autoimmune
- iatrogenic:
- surgery
- radiotherapy
- chemotherapy
- miscellaneous:
- head injury
- empty sella syndrome
- emotional deprivation
- starvation & anorexia nervosa
Notes:
- head injury and hypopituitarism (1)
- marked changes of the hypothalamo-pituitary axis have been documented
in the acute phase of traumatic brain injury(TBI)
- following TBI as many as 80% of patients showing evidence of gonadotropin deficiency, 18% of growth hormone deficiency, 16% of corticotrophin deficiency and 40% of patients demonstrating vasopressin abnormalities leading to diabetes insipidus or the syndrome of inappropriate anti-diuresis
- longitudinal prospective studies have shown that some of the early abnormalities are transient, whereas new endocrine dysfunctions become apparent in the post-acute phase. There remains a high frequency of hypothalamic-pituitary hormone deficiencies among long-term survivors of TBI, with approximately 25% patients showing one or more pituitary hormone deficiencies
- marked changes of the hypothalamo-pituitary axis have been documented
in the acute phase of traumatic brain injury(TBI)
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