Hypopituitarism
Description Diagnostic criteria Medicine treatment Referral ICD-10 Code: E23.0 DESCRIPTION Multiple or isolated deficiencies of adrenocorticoid hormone (ACTH), luteinising hormone, thyroid stimulating hormone, prolactin, and growth hormone manifesting as hypoglycaemia, abnormal body proportions and failure to grow and develop. If the posterior pituitary is involved (ADH deficiency), then this con
ICD-10 Code: E23.0
DESCRIPTION
Multiple or isolated deficiencies of adrenocorticoid hormone (ACTH), luteinising hormone, thyroid stimulating hormone, prolactin, and growth hormone manifesting as hypoglycaemia, abnormal body proportions and failure to grow and develop. If the posterior pituitary is involved (ADH deficiency), then this condition is known as panhypopituitarism.
The deficiency may be due to:
- congenital abnormalities with/without midline structural abnormalities of the brain,
- central nervous system tumours, e.g. craniopharyngioma, histiocytosis; and
- complications of radiation therapy.
DIAGNOSTIC CRITERIA
Clinical
- Neonates with hypopituitarism may present with:
- persistent hypoglycaemia,
- cholestatic jaundice (related to low cortisol), and
- micropenis.
- Short stature with normal or high BMI.
- Polydipsia, polyuria, nocturia and enuresis in the case of panhypopituitarism.
Investigations
- Endocrine evaluation with pituitary function tests under specialist supervision.
- Confirm diagnosis in older children with stimulation tests.
MEDICINE TREATMENT
To correct hypoglycaemia:
- Hydrocortisone, IV, 2-3 mg/kg.
REFERRAL
All patients after stabilisation of hypoglycaemia.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Paediatrics, 2023 Edition
Chapter 7: Endocrine, 7.11 Hypopituitarism