Hypopituitarism
What is it?
Hypopituitarism is the clinical condition where someone has low levels of pituitary hormones.
Most commonly caused by tumours in the pituitary compressing areas of the gland and preventing them from working properly. Can also be caused by loss of blood pressure during birth, as well as infection and head trauma.
Symptoms and Signs
Can be very varied, since the pituitary produces oxytocin, antidiuretic hormone, growth hormone, prolactin, follicle stimulating hormone, luteinizing hormone, thyroid stimulating hormone and adrenocortitrophic hormone.
Not having enough of each of these can cause a variety of weird symptoms, but the most common occurrence is for all the anterior hormones to get knocked out, leaving them:
- hypothyroid,
- low on growth hormone,
- amenorrhoeaic and
- suffering from adrenal insufficiency.
The combination of all these leads to hypoglycaemia, failure to thrive, fatigue, weight loss and generally being a mess.
If its caused by a tumour, as it gets bigger it can press on the optic chiasm, causing temporal field homonymous hemianopia, or other visual disturbance.
Going into a Coma
Medical Emergency - The main reason that this is an emergency is because it can lead to a Myxoedema coma if the thyroid hormone levels get too low, or a Addisonian crisis if the cortisol levels get too low!
Symptoms
Things get worse and worse, generally with headache, opthalmoplegia, lowered consciousness, hypotension, hypothermia. Sometimes happens quite acutely, if there's been a pituitary infarct.
Tests
Probably a Head CT to check it all out too.
Treatment
- First thing is hydrocortisone sodium succinate.
- Next is T3, to get the metabolism restarted.
- If its a tumour, or an infarct, probably will need surgery.