Hypopituitarism other than sellar and parasellar tumors or traumatic brain injury assessed in a tertiary hospital.

Sarwar Malik,Najmul Islam,Muhammad Qamar Masood,Zareen Kiran,Muhammad Owais Rashid,Minaz Mawani,Asma Gulab

doi:10.12669/pjms.35.4.174

Abstract

Objective:Data regarding the etiology, clinical and biochemical patterns in hypopituitarism is scant for Pakistan. We describe the characteristics of patients with hypopituitarism other than sellar and parasellar tumors or traumatic brain injury from a tertiary care center in Pakistan.Methods:We conducted a retrospective descriptive study in the Aga Khan University Hospital, Karachi, Pakistan. We studied all patients presenting with hypopituitarism, between January 2004 and December 2013. Clinical, hormonal and imaging data pertinent to the study was collected according to inclusion criteria.Results:Forty-two patients presented to the endocrinology clinics at the Aga Khan University Hospital during the study period. Thirty-seven patients (88.1%) were females. Mean age ± standard deviation of the participants was 53.8 ± 14.7 years. Sixteen patients had secondary infertility and all were females; a majority of patients in this group had Sheehan’s syndrome (n=8) followed by empty sella syndrome (n=3), partial empty sella syndrome (n=2), idiopathic cause (n=2) and tuberculoma (n=1). Eighteen females (48.6%) reported inability to lactate.Conclusions:Non-traumatic hypopituitarism was more common in women, with Sheehan syndrome being the most common cause of hypopituitarism in our study (35.7%). Secondary hypothyroidism was the most common hormonal deficiency. The most commonly reported symptom was weakness.

Highlights

The term hypopituitarism denotes the deficiency of one or more of the hormones of the anterior or posterior pituitary gland whereas, panhypopituita-Correspondence: December 10, 2018 May 17, 2019 May 20, 2019 rism is defined as the loss of all the pituitary hormones and the term is often used in clinical practice to describe patients with deficiency in growth hormone (GH), gonadotropins, corticotropin, and thyrotropin
Sheehan’s syndrome (n=15) were all women, tuberculoma of pituitary gland were found in women only (n=2), out of 10 patients having empty sella syndrome, seven were women, hypoplastic pituitary gland was found in two women and one man
Partial empty sella syndrome was found in six women and one man

Summary

Introduction

The term hypopituitarism denotes the deficiency of one or more of the hormones of the anterior or posterior pituitary gland whereas, panhypopituita-. Correspondence: December 10, 2018 May 17, 2019 May 20, 2019 rism is defined as the loss of all the pituitary hormones and the term is often used in clinical practice to describe patients with deficiency in growth hormone (GH), gonadotropins, corticotropin, and thyrotropin. The posterior pituitary function may remain intact in these patients.[1]. Other causes include pituitary apoplexy, Sheehan’s syndrome, stroke, traumatic brain injury and subarachnoid hemorrhage.

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Results

Conclusion