Diagnosis and Treatment of Hypopituitarism

Abstract

Hypopituitarism is a chronic endocrine illness that caused by varied etiologies. Clinical manifestations of hypopituitarism are variable, often insidious in onset and dependent on the degree and severity of hormone deficiency. However, it is associated with increased mortality and morbidity. Therefore, early diagnosis and prompt treatment is necessary. Hypopituitarism can be easily diagnosed by measuring basal pituitary and target hormone levels except growth hormone (GH) and adrenocorticotropic hormone (ACTH) deficiency. Dynamic stimulation tests are indicated in equivocal basal hormone levels and GH/ACTH deficiency. Knowledge of the use and limitations of these stimulation tests is mandatory for proper interpretation. It is necessary for physicians to inform their patients that they may require lifetime treatment. Hormone replacement therapy should be individualized according to the specific needs of each patient, taking into account possible interactions. Long-term endocrinological follow-up of hypopituitary patients is important to monitor hormonal replacement regimes and avoid under- or overtreatment.

Magnitude, Clinical Presentation and Outcome of Patients with Pituitary Lesions:An Experience from Tikur Anbessa Specialized Hospital, Ethiopia

“…Our patients with hypopituitarism improved with medical treatment. A review article on hypopituitarism recommends individualized doses of hormone replacement with long-term endocrinological follow up [24].…”

Growth Hormone & Hypopituitarism

“…It is to be noted, that physical development in early adulthood (between linear growth completion and 25 years age), treatment should be continued (if criteria for severe deficiency matched) till adult peak bone mass gained. Several studies have pointed that treatment continued throughout life is beneficial [1][2][3][4][5][6][7][8]. Moreover, elderly patients are more sensitive to Insulin-like growth factor-1 (IGF-1), so they require less dose of recombinant GH to achieve safer and effective level of IGF-1.…”

Long-acting FC-fusion rhGH (GX-H9) shows potential for up to twice-monthly administration in GH-deficient adults

“…Adult growth hormone deficiency (AGHD) is a recognized clinical syndrome associated with numerous metabolic abnormalities, including abnormal body composition, reduced physical performance, altered lipid metabolism, decreased bone mass, increased insulin resistance and reduced quality of life (1,2,3). Most metabolic abnormalities associated with AGHD can be reversed with recombinant human GH (rhGH) replacement (4).…”