Neonatal Hypopituitarism: Diagnosis and Treatment Approaches

Abstract

What is already known on this topic?The pituitary gland is the central regulator of growth, metabolism, reproduction and homeostasis. Hypopituitarism is defined as a decreased release of hypophysis hormones, which may be caused by pituitary gland disease or hypothalamus disease. Clinical findings for neonatal hypopituitarism depend on causes and hormonal deficiency type and degree. If early diagnosis is not made, it may cause pituitary hormone deficiencies. What this study adds?We aim to contribute to the literature through a review of etiological factors, clinical findings, diagnoses and treatment approaches for neonatal hypopituitarism. We also aim to increase awareness of neonatal hypopituitarism. We also want to emphasize the importance of early recognition. AbstractHypopituitarism is defined as a decreased release of hypophysis hormones, which may be caused by pituitary gland disease or hypothalamus disease. Clinical findings for neonatal hypopituitarism depend on causes and hormonal deficiency type and degree. Patients may be asymptomatic or may demonstrate non-specific symptoms, but may still be under risk for development of hypophysis hormone deficiency with time. Anamnesis, physical examination, endocrinological, radiological and genetic evaluations are all important for early diagnosis and treatment. Treatment of hypopituitarism patients is possible through treatment of hypophysis and hypothalamus disorders. The aim of this article is to contribute to the literature through a review of etiological factors, clinical findings, diagnoses and treatment approaches for neonatal hypopituitarism.

Ectopic Posterior Pituitary, Polydactyly, Midfacial Hypoplasia and Multiple Pituitary Hormone Deficiency due to a Novel Heterozygous IVS11-2A>C(c.1957-2A>C) Mutation in the <i>GLI2</i> Gene

“…However, the mutations in GLI2 are rarely associated with an HPE phenotype ( 7 , 12 ). Indeed, in the study of Bear et al ( 5 ) only three of the 112 (2.7%) patients with GLI2 mutations, had HPE ( 13 ). Also, neuroanatomical anomalies, such as agenesis of the corpus callosum, abnormal cerebral periventricular venous system and abnormal gyri have been reported in patients with GLI2 mutations ( 8 , 14 , 15 , 16 , 17 ).…”

Transfontanelle photoacoustic imaging for in-vivo cerebral oxygenation measurement

“…This includes the germinal matrix in neonates which can easily be ruptured due to immature formation and initiate Grade 1 and 2 intraventricular hemorrhages 35,36 . ROI #3 was considered near the pituitary gland around 3 cm from the brain surface which will provide insight of pituitary disfunction due to traumatic brain injury in neonates 37,38 . Since, superficial vasculatures (e.g., SSS and cortical veins) carry deoxygenated blood and moreover, PA estimated values are compared to arterial samples (fully oxygenated), we did not consider any ROI near the cortical surface.…”

Central Diabetes Insipidus in an Extremely-Low-Birth-Weight Preterm Infant with Suspected Ectopic Posterior Lobe of the Pituitary Gland

“…Although fluid and electrolyte disorders are frequent in pre term infants, we did not ignore the laboratory test results and conducted further studies. A water deprivation test is not recommended in neonates 10) . As a therapeutic trial, we subcutaneously has two or more of the following: optic nerve hypoplasia, pituitary hormone abnormalities, or midline brain defects 15) .…”

“…The morning cortisol level, measured on day 163 of life, was slightly low. However, there were no symptoms of adrenal insufficiency, and considering that a circadian rhythm in cortisol secretion requires approximately 6 months to stabilize 10) , the cortisol levels were followed up without medication. Serum cortisol level measured in a stress situation 1 month later was normal.…”