Hypopituarism - Not such an obvious symptom
DOI:
https://doi.org/10.12775/JEHS.2025.81.59372Keywords
hypopituarism, uremia, tertiary hypothyroidism, hypogonadism, cerebral lymphomaAbstract
This paper presents the case of a diagnostic and therapeutic challenge of a young 33-year-old man from Poland, who initially reported few symptoms and eventually turned out to be an interesting endocrine case
The pituitary gland is the central endocrine gland that controls the entire human endocrine system. Despite its small size, it dominates over the other endocrine glands. The pituitary gland is located inside the skull, in the so-called Turkish saddle. It secretes a number of hormones: growth hormone (GH), prolactin (PRL), adrenocorticotropic hormone (ACTH), thyrotropic hormone (TSH), folliculotropic hormone (FSH), luteinizing hormone (LH), melanotropin (MSH), oxytocin, vasopressin.
References
Daly AF, Trichomirowa MA, Beckers A. The epidemiology and genetics of pituitary adenomas. Best Pract Res Clin Endocrinol Metab 2009;23:543–554.
2. Dworakowska D, Grossman AB. The pathophysio- logy of pituitary adenomas. Best Pract Res Clin Endocri- nol Metab 2009;23:525–541.
3. ChansonP.Pituitarytumors.Preface.BestPractRes Clin Endocrinol Metab 2009;23:vii–viii.
4. Zgliczyński W, Plakkiewicz-Jankowska E: “Pituitary insufficiency” in Interna Szczeklika 2020/2021, Medycyna Praktyczna, Krakow 2020, pp. 789-792.
5. Colao A. Pituitary tumors: the prolactinoma. Best Pract Res Clin Endocrinol Metab 2009;23:575–596.
6. Kronenberg HM, Melmed S, Polonsky KS, Larsen PR. Williams textbook of endocrinology. 11th ed. Philadelphia: Saunders Elsevier; 2008.
7. Klibanski A. Clinical practice. Prolactinomas. N Engl J Med 2010;362:2142.
8. Casanueva FF, Molitch ME, Schlechte JA, et al. Guidelines of the Pituitary Society for the diagnosis and management of prolactinomas. Clin Endocrinol 2006; 65:265–273.
9. Kars M, Dekkers OM, Pereira AM, Romijn JA. Update in prolactinomas. Neth J Med 2010;68:104–112.
10. De Luca F, Bernasconi S, Blandino A, Cavallo L, Cisternino M. Auxological, clinical and neuroradiological findings in infants with early onset growth hormone deficiency. Acta Paediatr. 1995 May;84(5):561-5.
11. Ho KK; 2007 GH Deficiency Consensus Workshop Participants. Consensus guidelines for the diagnosis and treatment of adults with GH deficiency II: a statement of the GH Research Society in association with the European Society for Pediatric Endocrinology, Lawson Wilkins Society, European Society of Endocrinology, Japan Endocrine Society, and Endocrine Society of Australia. Eur J Endocrinol. 2007 Dec;157(6):695-700.
12. Alsaleem M, Saadeh L, Misra A, Madani S. Neonatal isolated ACTH deficiency (IAD): a potentially life-threatening but treatable cause of neonatal cholestasis. BMJ Case Rep. 2016;2016 doi: 10.1136/bcr-2016-215032. pii: bcr2016215032
13. Voutetakis A, Sertedaki A, Dacou-Voutetakis C. Pituitary stalk interruption syndrome: cause, clinical manifestations, diagnosis, and management. Curr Opin Pediatr. 2016;28:545–550. doi: 10.1097/MOP.0000000000000378.
14. Mazur A, Ostański M, Kalina M. Rodzinny niedobór glikokortykosteroidów. Endokrynologia, Diabetologia, i Choroby Przemiany Materii Wieku Rozwojowego. 2007;13:91–94.
15. Bornstein SR, Allolio B, Arlt W, Barthel A, Don-Wauchope A, Hammer GD. Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016;101:364–389. doi: 10.1210/jc.2015-1710. et al.
16. McMillen B, Dhillon MS, Yong-Yow S. A rare case of thyroid storm. BMJ Case Rep. 2016; 2016: 10.1136/bcr–2016, doi: 10.1136/bcr-2016- 214603, indexed in Pubmed: 27090545.
17. Torino F, Barnabei A, Paragliola RM, et al. mAbs and pituitary dysfunc- tion: clinical evidence and pathogenic hypotheses.Eur.J.Endocrinol. 2013;169:R153–R164.
18. Faje A. Immunotherapy and hypophysitis. Pituitary 2016; 19: 82–92.
19. Heraldo Mendes Garmes, Unidade de Neuroendocrinologia, Divisão de Endocrinologia e Metabologia, Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil, Management of hypopituitarism: a perspective from the Brazilian Society of Endocrinology and Metabolism
20. Rosén T, Bengtsson BA. Premature mortality due to cardiovascular disease in hypopituitarism. Lancet. 1990;336(8710):285-8
21. Wojtachnio D.,Osiejewska A., Bartoszewicz J., Grądzik A., Hypothyroidism:
clinical presentation, diagnosis, treatment. Journal of Education Health and Sport
12(8):650-660
22. Ambroziak, U. (2013). Wytyczne postępowania w niedoczynności tarczycy u dorosłych
Medycyna po Dyplomie, 3, 17-19.
23. LeFevre, Michael L., and US Preventive Services Task Force*. "Screening for thyroid
dysfunction: US Preventive Services Task Force recommendation statement." Annals
of internal medicine 162.9 (2015): 641-650.
24. Consensus guidelines for the diagnosis and treatment of adults with growth hormone
deficiency: summary statement of the growth hormone research society workshop on
adul growth hormone deficiency.: J. Clin. Endocrinol. Metab., 1998, 2, 379.
25. Mc Grath S., Morris M., Boulox P.M.: Growth Hormone and IGF Research, 1999, 9, 9.
26. Pappachan JM, Raskauskiene D, Kutty VR, Clayton RN. Excess mortality associated with hypopituitarism in adults: a meta-analysis of observational studies. J Clin Endocrinol Metab. 2015;100:1405–1411
27. Xatzipsalti M, Voutetakis A, Stamoyannou L, Chrousos GP, Kanaka-Gantenbein C. Congenital Hypopituitarism: Various Genes, Various Phenotypes. Horm Metab Res. 2019;51(2):81–90.
28. Abe SY, Dos Santos KS, Barbosa BF, Biondo CM, Takito D, Hayashi SK, et al. Metabolic syndrome and its components in adult hypopituitary patients. Pituitary. 2020;23(4):409–416.
29. Garmes HM, Castillo AR. Insulin signaling in the whole spectrum of GH deficiency. Arch Endocrinol Metab. 2019;63(6):582–591.
30. Verhelst J, Mattsson AF, Luger A, Thunander M, Góth MI, Koltowska-Häggström M, et al. Prevalence and characteristics of the metabolic syndrome in 2479 hypopituitary patients with adult-onset GH deficiency before GH replacement: a KIMS analysis. Eur J Endocrinol. 2011;165(6):881–889.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Monika Grzybek, Barbara Wilczyńska, Anna Kasprzak, Monika Kułaga, Diana Mazur-Lesińska, Barbara Szostak, Sylwia Wielgosz-Biała, Krzysztof Tyszkiewicz, Borys Łozowski, Małgorzata Kasprzak
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 149
Number of citations: 0
