Key Points

• Hypopituitarism refers to total or partial deficiency of one or more pituitary hormones.

• Hypopituitarism can result from a genetic disorder or releasing factor deficiency but more often results from pituitary tissue destruction secondary to mass expansion, infiltrative process, autoimmune or infectious disease, vascular accidents, radiation injury, or trauma.

• Pituitary apoplexy may result in life-threatening hypocortisolism.

• Lymphocytic hypophysitis is a rare autoimmune pituitary disease occurring in women in late pregnancy or postpartum that may mimic pituitary tumor but does not require resection.

• Kallmann syndrome is characterized by an isolated defect in GnRH secretion.

• Approximately 10% of patients with empty sella syndrome have clinically apparent hypopituitarism, and some may have pituitary adenomas.

• Systemic disease, including end-stage liver disease or chronic renal failure, is associated with variable degrees of hypopituitarism without significant histopathologic changes in the pituitary.

Hypopituitarism refers to total or partial deficiency of one or more pituitary hormones resulting in end-organ changes or reduced hormonal secretion of target endocrine glands (Toogood and Stewart, 2008). The deficiencies could be the result of primary disease of the pituitary or could be secondary to failure of hypothalamic hormone synthesis or transport. There are no good estimates of the incidence of hypopituitarism because the disease is often subclinical.

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