1 Star2 Stars3 Stars4 Stars5 Stars (No Ratings Yet)
Loading...

Hypopituitarism

  1. Reasons
  2. Symptoms
  3. Diagnosis
  4. Treatment


Hypopituitarism

it is a disease that develops as a result of violations of secretion of hormones of the pituitary gland (an area of the brain that regulates all of the endocrine glands) characterized by insufficiency of the functions of the peripheral organs of the endocrine system (adrenals, gonads, thyroid). Is also known as hypothalamic-pituitary failure.

Form

  • isolated hypopituitarism is a violation of only one of the tropic function of the pituitary gland
  • partial (partial) hypopituitarism is loss of two or more tropic functions of the pituitary gland
  • hypopituitarism lose absolutely all functions of the pituitary gland.

Reasons

Causes of hypopituitarism

  • brain tumor
  • pituitary failure develops as a result of death (necrosis) areas of the brain (pituitary)
  • the effects of the irradiation region of the hypothalamus or pituitary
  • the effects of any surgical interventions
  • inflammation of the pituitary gland.

Causes of postpartum hypopituitarism (Sheehan’s disease)

  • massive blood loss during childbirth
  • sepsis (septic condition) with the formation of a blood clot.

Symptoms

Below are the symptoms of pituitary insufficiency in adults

  • deficiency of somatotropin (growth hormone), which implies

    • decrease in muscle mass and increased body fat percentage due to the increase in organ (visceral) fat
    • increased risk of any fractures and reduced bone mineral density
    • decrease endurance for any physical activity
    • the increase in the content of cholesterol, which is followed by its deposition in the vessel walls (atherosclerosis)
    • a decrease in sweating, skin dryness and thinning
    • sleep disorder (sleepiness during day, insomnia at night)
    • psychological disorders low self-esteem, depression, a tendency to apathy
  • gonadotropin insufficiency (decrease in level of the genital organs)

    • women

      • amenorrhea, disturbance of the regularity of menstruation, infertility
      • atrophic changes of the vaginal mucosa (dry)
      • urinary incontinence
      • the decrease in breast size
      • significant reduction of sexual hair
      • the lack or reduction of libido
      • visible memory impairment.
    • men

      • the lack or reduction of libido, weakening of erection
      • the lack of ejaculation, loss of or weakening of orgasm
      • loss of hair on the face and body
      • folding of the scrotum, pale skin and thinning of the hair on the head
      • the reduction in the density and elasticity of the testicles
  • long-term (over a year) the deficit of sex hormones, which can lead to the development of osteoporosis and atherosclerosis
  • thyrotropic insufficiency (decrease in level of hormones of the thyroid gland)

    • reduced physical and mental activity, lethargy, drowsiness
    • hair loss, pallor and dryness of skin
    • bradycardia and low blood (arterial) pressure
    • the increase in body weight
    • dysfunction of the gastrointestinal tract
  • the clear lack of adrenocorticotropic hormone (decrease in hormonal level of the adrenal glands)

    • fatigue, weakness
    • the decrease in body mass
    • the decrease in the level of glucose in the blood (hypoglycemia)
    • lower blood (arterial) pressure

To identify hypopituitarism in children, it is necessary to pay attention to the following symptoms

  • deficiency of somatotropin (growth hormone deficiency), which is accompanied by

    • from an early age progressing growth retardation. If the child is diagnosed with a disease hypopituitarism, development of it will lag behind their peers for a couple of years.
    • symptoms

      • small features
      • short neck
      • little feet and brushes
      • round head
      • increased risk of fractures and decreased bone density
      • decreased stamina for any physical activity
      • reduces sweating, there is a thinning of the skin, is dryness
  • gonadotropin insufficiency (manifested in 1113 years)

    • boys

      • very high growth or dwarfism
      • eunuchoid body proportions (short torso, very long limbs)
      • the fat deposition on the female type (hips, buttocks)
      • increase breast (gynecomastia)
      • pale skin
      • penis up to 5 cm
      • high tone of voice
      • unpigmented scrotum, without folding
      • the complete lack of any libido.
    • girls

      • very high growth or dwarfism
      • eunuchoid body proportions (torso too short, too long limbs)
      • very poorly developed skeletal musculature
      • pale skin
      • the lack of hair in the armpits and pubic
      • tone of voice high
      • absent libido
      • the lack of growth of the breast mammary glands
      • the first menstruation is absent for up to 15 years
  • thyrotropic insufficiency

    • reduced physical and mental activity, lethargy, drowsiness
    • hair loss, pallor and dryness of skin
    • bradycardia and decrease in blood (arterial) pressure
    • the increase in body weight
    • dysfunction of the gastrointestinal tract
  • insufficiency of adrenocorticotropic hormone

    • fatigue, weakness
    • the decrease in body mass
    • the decrease in the level of glucose in the blood (hypoglycemia)
    • lower blood (arterial) pressure

Diagnosis

Diagnosis of hypopituitarism include

  • analysis of the history of diseases and complaints. The patient should clarify

    • when first had complaints of decrease in blood (arterial) pressure, complaints of weakness
    • often, whether the patient is ill with any infectious diseases
    • whether or not a stroke or traumatic brain injury
    • the woman should clarify whether copious blood loss in the first postpartum period
  • General inspection

    • pallor and dryness of skin
    • hair loss, lowering the frequency of heart beats
    • with the change of body position, sudden drop in blood pressure and dizziness when rising
    • reduction of mammary glands in women or an increase in men testicular atrophy
    • the appearance of excess subcutaneous fat and reduction in muscle mass
  • a blood test for cholesterol, ions, glucose, protein
  • determination of hormone levels in the blood

    • a complete study of the concentration of somatotropic hormone (growth hormone) in stimulating the samples, caused by the introduction of insulin
  • determination of the concentration of insulin-like growth factor 1 (this will affect the regulation of development and growth of cells) in the blood has a secondary importance for the full diagnostics of insufficiency of growth hormone

    • study of the level of follicle stimulating and luteinizing hormones
    • the study of the content of thyroxine and thyroid-stimulating hormone
    • determination of adrenocorticotropic hormone and cortisol levels in the morning on an empty stomach, cortisol in daily urine
  • x-rays of the bones (for General assessment of bone age)
  • densitometry (performed if failure of the pituitary gland in a patient observed for more than a year)
  • Ultrasound of the uterus, adrenals, ovaries, glands
  • computer and magnetic resonance tomography of the brain.

Treatment

If the patient is diagnosed with hypopituitarism, the treatment depends on the cause of the disease

  • if the patient discovered a tumor region of the brain, it is necessary to remove the mass
  • replacement therapy sex hormones (in men it is testosterone, and women have progesterone, estrogens). Also thyroid, adrenal hormones (somatotropin, glucocorticoids).

Prevention

  • careful monitoring of blood loss during childbirth and its replenishment
  • at least three years to comply with the interval between childbirth to restore the body’s normal composition of the blood
  • prevention of traumatic brain injury
  • diet rich in iron and vitamins
  • regular medical check-UPS.