aetiology

Last reviewed 01/2018

The aetiology of hypopituitarism includes:

  • neoplasms in the suprasellar region:
    • pituitary adenoma in adults
    • craniopharyngioma in children
    • glioma
    • meningioma
    • metastatic cancer

  • infiltration:
    • sarcoid
    • histiocytosis X
    • haemochromatosis

  • infection:
    • tuberculous meningitis
    • syphilis
    • encephalitis

  • vascular:
    • Sheehan's syndrome (post-partum infarction)
    • pituitary apoplexy
    • carotid artery aneurysms

  • autoimmune

  • iatrogenic:
    • surgery
    • radiotherapy
    • chemotherapy

  • miscellaneous:
    • head injury
    • empty sella syndrome
    • emotional deprivation
    • starvation & anorexia nervosa

Notes:

  • head injury and hypopituitarism (1)
    • marked changes of the hypothalamo-pituitary axis have been documented in the acute phase of traumatic brain injury(TBI)
      • following TBI as many as 80% of patients showing evidence of gonadotropin deficiency, 18% of growth hormone deficiency, 16% of corticotrophin deficiency and 40% of patients demonstrating vasopressin abnormalities leading to diabetes insipidus or the syndrome of inappropriate anti-diuresis
      • longitudinal prospective studies have shown that some of the early abnormalities are transient, whereas new endocrine dysfunctions become apparent in the post-acute phase. There remains a high frequency of hypothalamic-pituitary hormone deficiencies among long-term survivors of TBI, with approximately 25% patients showing one or more pituitary hormone deficiencies

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