5-Minute Clinical Consult: Hypopituitarism

Hypopituitarism

Etiology

Childhood:
- Genetic disorders
- Perinatal asphyxia
- Developmental disorders/pituitary hypoplasia, aplasia
- Craniopharyngioma, other tumors
- Cranial irradiation
- Head trauma
Adult:
- Pituitary tumors; most common etiology
- Other intrasellar or extrasellar tumors: Meningiomas, gliomas, metastases, craniopharyngiomas, chordomas, ependymomas
- Surgery on pituitary or adjacent structures
- Cranial irradiation
- Pituitary infarction, apoplexy
- Lymphocytic hypophysitis
- Postpartum hemorrhage with hypotension (Sheehan syndrome)
- Vascular: Internal carotid artery aneurysm, subarachnoid hemorrhage
- Head trauma (2)
- Infection:
  - Abscess, hypophysitis, meningitis, encephalitis
  - Tuberculosis, pneumocystis, histoplasmosis, toxoplasmosis, aspergillosis, cytomegalovirus
- Infiltrative conditions: Hemochromatosis, granulomatous disease, histiocytosis X
- Hypothalamic disease (secondary hypopituitarism)
- Autoimmune disease: Lymphocytic hypophysitis
- Chronic debilitating disease, nonspecific
- Other: Hemochromatosis, granulomatous diseases, histiocytosis
- Empty sella

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