Diagnosis and Treatment of Hypopituitarism

• Published in: Endocrinology and metabolism (Seoul) Vol. 30; no. 4; pp. 443 - 455
• Main Author: Kim, Seong Yeon
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Endocrine Society 01.12.2015; 대한내분비학회
• Subjects: Adrenocorticotropic hormone deficiency; Anti-diuretic hormone deficiency; Gonadotropin deficiency; Growth hormone deficiency; Hypopituitarism; Review; Thyrotropin deficiency; 내과학; Anti-diuretic hormone deficiency; Gonadotropin deficiency; Thyrotropin deficiency; Adrenocorticotropic hormone deficiency; Hypopituitarism; Growth hormone deficiency
• ISSN: 2093-596X; 2093-5978
• DOI: 10.3803/EnM.2015.30.4.443

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.