Generalized hypopituitarism refers to endocrine deficiency syndromes due to partial or complete loss of anterior lobe pituitary function. Various clinical features occur depending on the specific hormones that are deficient. Diagnosis involves imaging tests and measurement of pituitary hormone levels basally and after various provocative stimuli. Treatment depends on cause but generally includes removal of any tumor and administration of replacement hormones.

Hypopituitarism is divided into

Primary: Caused by disorders that affect the pituitary gland

Secondary: Caused by disorders of the hypothalamus

The different causes of primary and secondary hypopituitarism are listed in the table below (see Table: Causes of Hypopituitarism).

Causes primarily affecting the pituitary gland (primary hypopituitarism)

Infarction or ischemic necrosis

Hemorrhagic infarction (pituitary apoplexy)

Vascular thrombosis or aneurysm, especially of the internal carotid artery

Meningitis (tubercular, other bacterial, fungal, malarial)

Idiopathic isolated or multiple pituitary hormone deficiencies

Drugs (eg hypophysitis due to antimelanoma monoclonal antibodies)

Causes primarily affecting the hypothalamus (secondary hypopituitarism)

Neurohormone deficiencies of the hypothalamus

Surgical transection of the pituitary stalk

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Generalized Hypopituitarism - Endocrine and Metabolic ...

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