Hypopituitarism

Hypopituitarism – is a pathological syndrome that manifests itself as a complete (panhypopituitarism) or partial (partial hypopituitarism) impaired secretion of hormones by the anterior pituitary gland (adenohypophysis). Congenital and acquired hypopituitarisms are distinguished, the latter in turn is divided into primary (with damage to the pituitary gland) and secondary (with damage to the hypothalamus).
Defects in the posterior lobe of the pituitary gland (neurohypophysis), the middle group of nuclei of the hypothalamus, cause hyposecretion of antidiuretic hormone (arginine-vasopressin; ADH); this syndrome is called diabetes insipidus.

Symptoms of hypopituitarism

In the primary acquired hypopituitarism, in most cases, the hyposecretion of hormones occurs in a specific sequence:
• STH – deficiency:
In childhood, somatotropic hormone deficiency can manifest itself in pituitary nanism, in adolescence and adulthood somatotropin regulates not only the linear growth of organism, but also chondrogenesis and bone mineralization. STH deficiency leads to impaired bone metabolism, water-salt metabolism, fat metabolism, cardiovascular disorders, etc. Often the symptoms of somatropin deficiency are interpreted as fatigue, the symptoms include a decrease in muscle strength and endurance, a tendency to depression, sleep disturbance. There is also an increase in blood cholesterol, a decrease in bone mineral density, an increase in visceral fat, a decrease in sweating, and skin thinning and dryness.
• LH and FSH – deficiency:
Symptoms of luteotropic and follicle-stimulating hormone deficiency include menstrual disorders in women, reduced potency in men. In addition to sexual disorders in patients with a long-existing hyposecretion of gonadotropic hormones (hypogonadism), osteoporosis, memory loss, atherosclerosis, and lipid metabolism, etc can develop.
• TSH – deficiency (secondary hypothyroidism):
The cause of damage to most organs in hypothyroidism is a decrease in the production of cellular enzymes as a result of a deficiency of thyroid hormones. Typical manifestations of hypothyroidism are lethargy, drowsiness, decreased activity, dry and pale skin, bradycardia, lower blood pressure, hair loss, constipation and other symptoms.
• ACTH – deficiency (secondary hypocorticism):
It is the most dangerous manifestation of hypopituitarism; its symptoms primarily include glucocorticoid adrenal insufficiency, reduced immunity, depigmentation of the skin, anorexia, hypotension, general weakness and other symptoms. Inadequate treatment of hypocorticism may result in acute adrenal insufficiency, which can lead to death.
If there is a shortage of products of several hormones, all of the above symptoms can be combined and overlap.
Coca hypopituitarism is also possible, due to the effects of cocaine on the vascular network that feeds the pituitary gland.

Treatment of hypopituitarism

In case of suspected hypopituitarism, an endocrinological examination of the content of the pituitary tropic hormones in the blood, additional examinations of the peripheral endocrine glands, and then a differential diagnosis of the disease must be conducted.