Health

How common is pituitary insufficiency after traumatic brain injury (TBI)? The overall incidence of TBI in the United States has been estimated to be 538 cases per 100,000. The likelihood of pituitary insufficiency is directly related to the severity of the injury. Anterior pituitary deficiencies are more common acutely than 3 and 12 months afterward. …

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What is the role of pituitary magnetic resonance imaging (MRI) scanning in hypopituitarism? Any patient with unexplained hypopituitarism or hyperprolactinemia, or with symptoms of tumor mass effect should undergo pituitary MRI scanning with and without contrast. Patients with suspected functional hypopituitarism (i.e., after use/abuse of anabolic–androgenic steroids or glucocorticoids) do not usually need pituitary imaging. …

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How is hypopituitarism diagnosed? In the setting of typical and overt manifestations of hypopituitarism, basal serum hormone measurements may suffice. However, in patients with more subtle manifestations, dynamic endocrine testing may be indicated. • ACTH deficiency: Nonspecific laboratory findings include hyponatremia, normochromic, normocytic anemia, and eosinophilia. In the noncritical setting, morning (7–9 am) serum cortisol levels < …

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Are there any signs on physical examination that suggest pituitary insufficiency? Other than delayed relaxation of deep tendon reflexes in patients with overt hypothyroidism (Woltman’s sign), there are no specific or pathognomonic findings on physical examination in patients with hypopituitarism. • ACTH deficiency: Postural hypotension, tachycardia, pallor, alopecia, and areolar hypopigmentation. Women with longstanding ACTH deficiency often …

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First symptoms of pituitary insufficiency The clinical manifestations of hypopituitarism depend on the extent and severity of the specific pituitary hormone deficiencies. If the onset is acute, the patient may be critically ill and present with hypotension and shock, obtundation, and even coma. However, if the onset is chronic and the pituitary deficiency is mild, …

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What causes pituitary insufficiency? Almost any disease that disturbs the normal interaction between the hypothalamus and the pituitary gland can produce anterior pituitary insufficiency. The most common cause of hypopituitarism is pituitary dysfunction associated with a pituitary adenoma and/or the effect of its treatment (surgery and/or radiation therapy). Among patients with pituitary macroadenomas, one third …

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How common is hypopituitarism in the general population? A study conducted in northwestern Spain revealed that the incidence of hypopituitarism was 4.2 cases per 100,000 per year and that the prevalence was 45 cases per 100,000. There were no gender differences in this survey.