Profile of adult hypopituitarism: A single-center experience

Abstract

Context : The incidence of hypopituitarism in the general population is 4 in 100,000, but there is a paucity of data on hypopituitarism. There are only two studies published from India on hypopituitarism. Aims: To study the clinical profile of hypopituitarism in a tertiary care center in Kerala. Settings and Design: This study was carried out in patients attending medicine and endocrinology outpatient and inpatient departments in Pushpagiri Medical College Hospital, Tiruvalla, Kerala between September 2013 and November 2014. Subjects and Methods: The study included 36 subjects of adult acquired hypopituitarism. Relevant clinical, hormonal, and imaging data were collected. Dynamic testing was done when necessary. Deficiency of hormones was defined based on standard recommendations. Results: The mean age was 48.6 years. There were 22 (59%) males and 14 females (41%). The most common presentation included altered sensorium (44.4%), hypogonadism, and menstrual irregularity (22.22%). As for the etiology of hypopituitarism, tumors (pre- and post-operative) comprised 58.3% of cases. Empty sella was found in 19.4% of patients with postsnake bite hypopituitarism (Simmonds syndrome) in 13.8%. Panhypopituitarism was seen in 86% of patients. Conclusions: Hypopituitarism is much more common than previously thought, and there is a delay in diagnosis either due to clinical inertia or due to its late and subtle presentation. The most common cause of hypopituitarism in a tertiary care center is pituitary tumors, and the most common presenting complaint is altered sensorium.