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Panhypopituitarism
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Panhypopituitarism

(PHP; Underactive Pituitary Gland)

Pronounced: Pan-HI-po-pah-TWO-ah-ta-ree-sm

En Español (Spanish Version)

Definition

Hypopituitarism is a condition in which the pituitary gland does not produce enough hormones it normally makes. Panhypopituitarism is a condition in which the pituitary gland does not produce any hormones; in other words, it shuts down. It is most noticeable when it occurs in children, because their growth is stunted and dwarfism can occur.

Pituitary Gland

Nucleus factsheet image

© 2008 Nucleus Medical Art, Inc.

Causes

Panhypopituitarism is typically caused by damage to the pituitary gland.

In children, damage to the pituitary gland may be caused by:

  • Infection
  • Stroke
  • Genetic factors
  • Tumor on the pituitary gland
  • Cancer that has spread
  • Injury
  • No known cause

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. The following factors increase your chance of developing panhypopituitarism:

Symptoms

Symptoms arise from:

  • Compression from tumor
    • Blurred vision
    • Loss of visual field
    • Poor temperature control
  • Insufficient hormones
    • Insufficient levels of gonadotropins
      • In premenopausal women, this causes missing menstrual cycles, infertility , osteoporosis , vaginal dryness, as well as loss or reduction in female characteristics.
      • In men, this causes impotence , reduced size of testes, decreased production of sperm, infertility , breast enlargement, reduced muscle mass, and loss or reduction in male characteristics (eg, beard growth).
    • Insufficient levels of growth hormone
      • In children, this causes stunted growth or dwarfism
      • In adults, this causes weakness, obesity , reduced cardiac output, low blood sugar levels, and reduced exercise tolerance.
    • Insufficient levels of thyroid-stimulating hormones
      • This leads to underactive thyroid , which causes confusion, hair loss, weakness, slow heart rate, muscle stiffness, intolerance to cold, constipation , weight gain, and dry skin.
    • Insufficient corticotrophic levels
      • This leads to underactive adrenal gland, which causes low blood pressure, low blood sugar , fatigue, weight loss, vomiting, and low stress tolerance.
    • Excessive prolactin levels
      • This causes women to have missed periods, infertility, and milk secretion.
      • In men, this causes reduced facial and body hair and small testes.

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam.

Tests may include the following:

  • MRI scan —a test that uses magnetic waves to make pictures of structures inside the body
  • Blood tests—to measure hormone levels
  • Stimulation tests—to test the reserve of the endocrine glands, especially the pituitary gland
  • Semen analysis—in males suspected of infertility

Treatment

Talk with your doctor about the best treatment plan for you. Treatment depends on the cause of the condition. The goal of treatment is to restore normal hormone production of the pituitary gland.

Treatment options include:

  • Hormone replacement therapy—Hormone replacement therapy is based on what types of hormones are deficient.
  • Tumor removal—Tumor removal is done if the cause of the damage is a tumor.
  • Radiation therapy —Radiation therapy is done if the cause of the damage is a cancer or tumor.

Prevention

The majority of causes of panhypopituitarism are not preventable. Preventing injury to the pituitary gland can reduce the risk of developing this condition when it is caused by injury.

RESOURCES:

The Endocrine Society
http://www.endo-society.org

The Hormone Foundation
http://www.hormone.org/

The Pituitary network
http://www.pituitary.org

CANADIAN RESOURCES:

BC Health Guide
http://www.bchealthguide.org/

Health Canada
http://www.hc-sc.gc.ca/index_e.html

References:

Diabetes & other endocrine and metabolic disorders: hypopituitarism. Lucile Packard Children's Hospital website. Available at: http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/diabetes/hypop.html . Accessed May 30, 2007.

Geffner M. Panhypopituitarism. The Magic Foundation website. Available at: http://64.233.167.104/search?q=cache:MHUYAhcYci8J:https://www.magicfoundation.org/downloads/PanPitpdf669.pdf+Panhypopituitarism&hl=en&ct=clnk&cd=8&gl=us . Accessed May 30, 2007.

Schneider HJ, Aimaretti G, Kreitschmann-Andermahr I, et al. Hypopituitarism. Lancet. 2007;269:1461-1470.

Toogood AA, Stewart PM. Hypopituitarism: clinical features, diagnosis, and management. Endocrinol Metab Clin North Am. 1998;37:235-261

What is a growth disorder? KidsHealth: Medical Problems: Endocrine Glands, Growth, & Diabetes. The Nemours Foundation website. Available at: http://kidshealth.org/parent/medical/endocrine/growth_disorder.html . Accessed May 30, 2007.



Last reviewed May 2008 by David Juan, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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