Clinical features of anterior pituitary hypofunction

Abstract

Objective To investigate the common etiology, clinical manifestations and abnormal hormone levels of anterior pituitary hypofunction (APH). Methods A retrospective analysis was performed on 140 patients diagnosed with APH at Department of Endocrine & Metabolic Diseases, Fujian Provincial Hospital from January 2013 to January 2017. Basic clinical data were collected to analyze the common causes of APH, main clinical manifestations and laboratory examination results of the patients. Results Among all 140 patients, 30 (21.4%) were pituitary adenoma patients, 28 (20.0%) were postoperative pituitary adenoma patients, 18 (12.9%) suffered from pituitary hypofunction caused by craniocerebral radiotherapy, 16 (11.4%) developed pituitary stalk interruption syndrome, and 15 (10.7%) had with Sheehan syndrome. There were 67 (94.4%) cases of growth hormone deficiency (growth hormone function measured in only 71 of 140 subjects), 114 (81.4%) cases of gonadal hormone deficiency, 113 (80.7%) cases of thyroid hormone deficiency and 107 (76.4%) cases of adrenocortical hypofunction. Fatigue in 40 (28.6%) cases and delayed growth in 13 (9.3%) cases were the most common complaints, headache in 11 (7.9%) and visual impairment in 10 (7.1%) were the most common symptoms. In male patients, hormonal abnormalities included growth hormone deficiency (94.6%, 53/56), gonadal hormone deficiency (85.0%, 68/80), thyroid hormone deficiency (81.3%, 65/80), and adrenocortical hormone deficiency (78.8%, 63/80). In femal patients, hormonal abnormalities included growth hormone deficiency (93.3%, 14/15), thyroid hormone deficiency (80.0%, 48/60), gonadal hormone deficiency (76.7%, 46/60), and adrenocortical hormone deficiency (73.3%, 44/60). Conclusions The most common reason leading to APH is pituitary adenoma, followed by pituitary adenoma after surgery. The most common complaint is fatigue. The most important hormone abnormalities are? growth hormone and gonadal hormone. There are differences in hormone abnormality caused by APH in different genders. Key words: Hypopituitarism; Clinical features; Pituitary hormones; Etiology