Materiały źródłowe

• #1 Hypopituitarism (Panhypopituitarism): Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/122287-overview

  Hypopituitarism is listed as a rare disorder by the National Institutes of Health (NIH), affecting less than 200,000 individuals in the United States. Internationally, hypopituitarism has an estimated incidence of 4.2 cases per 100,000 per year and an estimated prevalence of 45.5 cases per 100,000 (without gender difference). […] A study by Regal et al detailing hypopituitarism in an adult population of 146,000 in northwestern Spain found a prevalence of 45.5 cases per 100,000 population. […] Generally speaking, the incidence of permanent pituitary deficiency following traumatic brain injury (TBI) is underestimated. The incidence/prevalence of hypopituitarism following TBI varies significantly between studies, with Gray et al finding, through the use of different reports, the prevalence of TBI-associated hypopituitarism to be 15-90%.

• #1 Prevalence and incidence of hypopituitarism in an adult Caucasian population in northwestern Spain – PubMed

  https://pubmed.ncbi.nlm.nih.gov/11895214/

  Objective: To determine the prevalence and incidence of hypopituitarism in the general population. […] The study population comprised an average population sample of 146,000 adult inhabitants in South Galicia (northwestern Spain). The Medical Register of the General Hospital of Vigo ensured virtually complete case ascertainment for diagnosed hypopituitarism in this sample population. […] In the first survey the prevalence of hypopituitarism was 29/100,000 (CI, 19.88-37.72), without sex differences. In the second survey, the prevalence observed was higher than in the first, 45.5/100,000 (CI, 34.92-56.08). […] In the longitudinal study with a population of 1,020,764 people-years of observation, the average annual incidence rate of hypopituitarism was 4.21 cases/100,000 (CI, 2.95-5.47), with this incidence being similar for both sexes. The annual incidence of hypopituitarism remained stable during the study period. […] We present for the first time data on the prevalence and incidence of hypopituitarism in the general adult population.

• #1 Hypopituitarism – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470414/

  Hypopituitarism is categorized as a rare disorder by the National Institute of Health (NIH), with limited data available on the incidence and prevalence of the condition. A study conducted by Regal et al in Northwestern Spain reported a prevalence of 45.5 cases per 100,000 population. […] Hypopituitarism is associated with an increased mortality risk from cardiovascular and respiratory diseases. Early detection of hypopituitarism is imperative, given its subtle symptoms that may lead to additional health complications.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Hypopituitarism-Epidemiology.aspx

  Hypopituitarism is considered to be a rare disorder. There are less than 200,000 patients with hypopituitarism in the United States. […] On a global basis, the incidence is estimated to be 4.2 cases per 100,000 per year, and the prevalence is approximately 45.5 cases per 100 000 people. These figures are indicative of the general population and have not been adjusted for gender or specific groups at risk. […] It is generally accepted that some population groups are at an increased risk of permanent pituitary deficiency and hypopituitarism. This includes individuals that have a history of traumatic brain injury or aneurysmal subarachnoid hemorrhage. However, the incidence of the condition in these populations remains to be determined, as there is insufficient research to estimate epidemiological parameters.

• #1 Hypopituitarism epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Hypopituitarism_epidemiology_and_demographics

  In a longitudinal survey (1992-1999), the incidence of hypopituitarism was estimated to be 4.2 cases per 100,000. A study comprising two cross-sectional surveys showed the prevalence of hypopituitarism to be 29 – 45.5 per 100.000 individual. […] There is one study performed in northern Spain, regarding hypopituitarism epidemiology combining two cross-sectional surveys (from 1992 and 1999). […] In a longitudinal survey (1992-1999), the incidence of hypopituitarism was estimated to be 4.2 cases per 100,000. […] The prevalence of hypopituitarism was found to be 29 – 45.5 per 100,000 individual in the two cross-sectional studies. […] Men and women are affected equally by hypopituitarism. […] Hypopituitarism occurs at any age. […] There is no racial predilection for hypopituitarism.

• #1 Causes of hypopituitarism – UpToDate

  https://www.uptodate.com/contents/causes-of-hypopituitarism

  In a study that comprised two cross-sectional surveys (from 1992 and 1999) of over 146,000 adults in northern Spain, the prevalence of hypopituitarism was 29 of 100,000 in the first survey and 45.5 of 100,000 in the second. A longitudinal survey was also performed; the average annual incidence of hypopituitarism was 4.2 cases of 100,000 (similar for males and females). In the second survey (which included most cases registered in the first survey), the causes of hypopituitarism included pituitary tumor (61 percent), nonpituitary tumor (9 percent), and a nontumor cause (30 percent). […] A study of 773 adults with hypopituitarism found the following distribution of etiologies.

• #1 Hypopituitarism (Panhypopituitarism): Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/122287-overview

  A systematic review of 13 observational studies found an estimated prevalence of 27.5% for chronic phase anterior hypopituitarism following TBI. […] A study by Claessen et al found that out of 133 female athletes with a history of one or more mild TBIs, 66.2% demonstrated pituitary hormone screening blood test results outside the reference values, signaling possible hypopituitarism. […] Hypopituitarism may also develop following intracranial bleeding, particularly in cases of aneurysmal subarachnoid hemorrhage (SAH). A systematic review found the pooled prevalence of hypopituitarism following aneurysmal SAH to be 31% at 3-6 months and 25% at over 6 months.

• #1 Hypopituitarism after traumatic brain injury in adults: Clinical guidelines of the neuroendocrinology area of the Spanish Society of Endocrinology and Nutrition (SEEN) | Endocrinología, Diabetes y Nutrición (English ed.)

  https://www.elsevier.es/es-revista-endocrinologia-diabetes-nutricion-english-ed–413-articulo-hypopituitarism-after-traumatic-brain-injury-S253001802300152X

  Hypopituitarism after traumatic brain injury in adults: Clinical guidelines of the neuroendocrinology area of the Spanish Society of Endocrinology and Nutrition (SEEN) […] The first description of hypopituitarism after TBI dates from 1918. Many studies have subsequently shown that cranial trauma is associated with pituitary hormone dysfunction. In a series of adult patients with hypopituitarism, TBI was the cause in 1.4% of cases, though its current impact is expected to be higher due to greater recognition and research. […] The published studies on the prevalence of hypopituitarism after TBI show variable results, probably because of their heterogeneity in terms of trauma severity and diagnostic methodology. In a meta-analysis of 2007, the overall prevalence of hypopituitarism after TBI was 27.5%, and varied by severity of TBI, assessed using the Glasgow Coma Scale. It was 35.3% in severe cases (GCS8), 10.9% in moderate cases (GCS 912), and 16.8% in mild cases (GCS13). Most studies, but not all, found greater prevalence with greater trauma severity, and most cases considered mild required hospitalisation and/or neurosurgical intervention.

• #1 Hypopituitarism | MedLink Neurology

  https://www.medlink.com/articles/hypopituitarism

  Another study found an even higher prevalence of pituitary dysfunction after aneurysmal subarachnoid hemorrhage, but this does not affect 6- to 12-month clinical outcomes: pituitary dysfunction (particularly dysfunction of the pituitary-gonadal axis) was present in 92% of cases in the acute phase, in 83% in the subacute phase, and in 83% in the chronic phase. […] Some studies have shown an association between the severity of traumatic brain injury and development of post-traumatic hypopituitarism, with hypopituitarism more frequent among patients with severe traumatic brain injury. […] The rates of neuroendocrine dysfunction after acute aneurysmal subarachnoid hemorrhage have been extremely variable, ranging from 4% to 92% in different studies less but still considerable variability in patients with chronic aneurysmal subarachnoid hemorrhage.

• #1 Prevalence of hypopituitarism in survivors of adult onset, primary, non-pituitary, brain tumours treated with intensity-modulated radiotherapy | SFEIES24 | Joint Irish-UK Endocrine Meeting 2024 | Endocrine Abstracts

  https://www.endocrine-abstracts.org/ea/0104/ea0104p133

  Prevalence of hypopituitarism in survivors of adult onset, primary, non-pituitary, brain tumours treated with intensity-modulated radiotherapy […] The risk of hypopituitarism in survivors of adult-onset, primary, non-pituitary brain tumours following IMRT is poorly understood. […] Hypopituitarism was diagnosed in 38% (26/69) of patients after a median of 50 (IQR 29-76) months follow up. […] These findings demonstrate a high prevalence of hypopituitarism in survivors of adult-onset brain tumours treated with IMRT; almost two-fifths of patients were affected by 50 months. […] Long-term systematic endocrine surveillance is essential for early diagnosis and treatment of hormone deficits to potentially improve quality of life and prevent hypopituitarism-related complications.

• #1 Pediatric Hypopituitarism: Practice Essentials, Etiology, Epidemiology

  https://emedicine.medscape.com/article/922410-overview

  MPHD is rare in childhood, with a possible incidence of fewer than 3 cases per million people per year. The most common pituitary hormone deficiency, GHD, is much more frequent; a US study reported a prevalence of 1 case in 3480 children. A 2001 population study in adults in Spain estimated the annual incidence of hypopituitarism at 4.2 cases per 100,000 population. The estimated incidence of congenital hypopituitarism is 1 in 4000 to 10,000. […] Because hypopituitarism has congenital and acquired forms, the disease can occur in neonates, infants, children, adolescents, and adults.

• #1 Sheehan syndrome | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/sheehan-syndrome?lang=us

  Sheehan syndrome is a rare cause of pituitary apoplexy and hypopituitarism. It only occurs in postpartum females who experience large volume hemorrhage and hypovolemic shock, either during delivery or afterward with resultant necrosis of anterior pituitary cells. […] Advances in obstetrical care mean Sheehan syndrome is rare in developed countries. The incidence in developing and low-income countries is as high as 5 in 100,000 births.

• #1 SciELO Brazil – Management of hypopituitarism: a perspective from the Brazilian Society of Endocrinology and Metabolism Management of hypopituitarism: a perspective from the Brazilian Society of Endocrinology and Metabolism

  https://www.scielo.br/j/aem/a/YmWnbJ9K4qjG3S7twVCLx3z/

  The prevalence of hypopituitarism following traumatic brain injury (TBI) is extremely variable across studies, with percentages ranging from 16% to 69% (owing mainly to differences in study populations, severity of trauma, time of evaluation, and laboratory criteria used to define pituitary deficiency), while some authors consider these rates to be overestimated. Brazilian investigators have studied the association between low LH and testosterone levels with morbidity and mortality during the acute phase of severe TBI, but the role of these hormones as prognostic factors is still uncertain. […] Hypophysitis, another frequently underdiagnosed cause of hypopituitarism, is related to an inflammatory process of the pituitary and may be classified as primary or secondary, depending on its etiology. Primary hypophysitis has a prevalence in the population of approximately 0.20.88% and an annual incidence of 1/9,000,000. The most common form of hypophysitis is lymphocytic or autoimmune, corresponding to approximately 72% of the cases. Secondary hypophysitis is related to inflammatory (sarcoidosis, granulomatosis with polyangiitis), infectious (tuberculosis, syphilis, fungal infections), or infiltrative (hemochromatosis, amyloidosis, Langerhans-cell histiocytosis) diseases, or may be drug-related, as observed with two classes of immune checkpoint inhibitors, namely, cytotoxic T lymphocyte associated antigen (CTLA-4) and programmed cell death protein 1 receptor (PD-1) inhibitors.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Hypopituitarism-Epidemiology.aspx

  Other risk factors, such as age, gender, ethnic origin and geographical location, have not yet been identified and there are no clear trends in the incidence or prevalence of hypopituitarism. […] The first scientific study to investigate the prevalence and incidence of hypopituitarism was carried out by Regal et al in Spain with a sample population size of 146 000. In this group of people, the prevalence of hypopituitarism was found to be 45.5 cases per 100,000. […] The standardized mortality rate was 8.05, which is eight times higher than in the general population. It was highest in young males. However, reduced survival rates were recognized to be also related to other coexisting or concurrent factors such as cancer, a history of radiotherapy, a high BMI, acromegaly and diabetes mellitus not under control. Further research is required to support these findings.

• #1

  https://link.springer.com/article/10.1007/s11154-024-09888-8

  In fact, a large population-based, propensity score-matched cohort study of patients with hypopituitarism hospitalized for acute medical conditions recently demonstrated that hypopituitarism was independently associated with increased in-hospital mortality with an odds ratio (OR) of 1.32 (95% CI, 1.061.65). […] The increased mortality was primarily seen in individuals with concomitant AVP deficiency (OR 3.27; 95% CI, 2.224.83), whereas it was not increased in individuals with hypopituitarism without posterior pituitary deficiency (OR 0.78; 95% CI, 0.601.03). […] A recent population-based study of hospitalized patients with secondary AI and propensity-matched controls from the general population showed that secondary AI was associated with significantly higher rates of ICU admission and intubation as well as a prolonged length-of-hospital stay by approximately 3.3 days (95% CI, 2.823.71). […] Furthermore, patients with secondary AI had an approximately 45% increased relative risk of hospital readmission even up to one year after the index hospitalization, highlighting the high burden of disease associated with secondary AI.

• #1

  https://link.springer.com/article/10.1007/s11154-024-09888-8

  Hypopituitarism is a highly heterogeneous multisystem disorder that can have a major impact on long-term morbidity and mortality, but even more so during acute medical conditions requiring hospitalization. […] Recent studies suggest a significant in-hospital burden with prolonged length of stay, increased rate of intensive care unit (ICU) admission, and initiation of mechanical ventilationall of which may lead to an increased risk of in-hospital mortality. […] Early epidemiologic studies suggested that compared to the general population, individuals with hypopituitarismin particular female patients have an increased long-term standardized mortality ratio (SMR) due to a higher incidence of cardiovascular and cerebrovascular events. […] More recently, it has been suggested that the higher overall mortality might be also caused by unplanned hospitalizations and associated in-hospital morbidity and mortality.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Hypopituitarism-Epidemiology.aspx

  Some medical scientists have expressed that the true prevalence of the disorder is likely to be considerably greater than indicated in these studies, due to the known difficulties in diagnosing the condition. Based on this, they recommended that hypopituitarism should not be viewed as a rare disease.

• #1 Audit of pituitary dysfunction post moderate to severe traumatic brain injury and proposed surveillance guidance | BSPED2024 | 51st Annual Meeting of the British Society for Paediatric Endocrinology and Diabetes | Endocrine Abstracts

  https://www.endocrine-abstracts.org/ea/0103/ea0103oc10.6

  A recent case of a seven-year-old boy developing diabetes insipidus, central hypothyroidism and growth hormone deficiency following a severe traumatic brain injury (TBI) highlighted a lack of surveillance for post-TBI pituitary dysfunction within the tertiary paediatric hospital of Northern Ireland. […] Evidence suggests post-TBI hypopituitarism occurs fairly frequently in children; with prevalence of isolated hormonal deficits 22.5% – 86% and multiple hormonal deficiencies 5.9% -50%. […] A NICE Evidence Review in 2023 reported There is currently no guidance for the screening and detection of hypopituitarism patients with TBI, with significant variation in practice. […] Monitoring of pituitary function in this patient cohort is sporadic, and often minimal or non-existent despite evidence of the risk of developing hypopituitarism within five years post TBI.

• #1 An Update on Subclinical Hypopituitarism

  https://www.iomcworld.com/open-access/an-update-on-subclinical-hypopituitarism-14247.html

  Subclinical deficiency of pituitary hormones represents an intermediate situation among normal pituitary secretion and overt hypopituitarism. […] Long-term controlled studies are needed to establish a correct definition of subclinical hypopituitarism and to know its clinical implications, optimal methods of diagnosis, and indications for substitutive treatment. […] There are few data available about the prevalence and incidence of hypopituitarism in the general population. […] Data about the epidemiology of subclinical hypopituitarism have not been reported in the general population, although there are studies evaluating subclinical pituitary deficiencies in some specific subgroups of patients. […] As previously mentioned, subclinical hypopituitarism does not produce symptoms that can be seen, and the methods for diagnosis are not well established. These conditions probably make subclinical hypopituitarism an underdiagnosed disorder.

• #1 Panhypopituitarism — Rare Genomics Institute

  https://www.raregenomics.org/panhypopituitarism

  What is the prevalence of Panhypopituitarism? Internationally, hypopituitarism has an estimated incidence of 4.2 cases per 100,000 per year and an estimated prevalence of 45.5 cases per 100,000 without gender difference. […] Are there any clinical trials underway for Panhypopituitarism? The National Institutes of Health (NIH) has completed 2 clinical trials for Panhypopituitarism. Currently, there are 4 clinical trials underway for the condition. More information on future studies and patient recruitment can be found here: https://clinicaltrials.gov.

• #1 Hypopituitarism – Dermatology Advisor

  https://www.dermatologyadvisor.com/home/decision-support-in-medicine/endocrinology-metabolism/hypopituitarism-2/

  Hypopituitarism is caused by diseases that affect the pituitary gland itself to decrease hormone production directly, or by disorders affecting the hypothalamus or pituitary stalk that interfere with generation or transmission of hypothalamic releasing factors. The most common cause of hypopituitarism (70-80% of all cases) is pituitary or peripituitary mass lesions or is a consequence of surgery or radiation used to treat such tumors. The incidence is 1-4 new cases per 100,000 population per year. Hypopituitarism may be acquired or congenital and affects males and females at an equal rate. There are no known variations in incidence-based on ethnic or geographic factors. […] Hypopituitarism frequently develops after radiation treatment of pituitary tumors, other intracranial tumors and head and neck malignancies with an onset anywhere from a few months after radiation until 10 years or more after. Therefore, annual testing of pituitary hormones is advised for patients who have received pituitary radiation.

• #1 Hypopituitarism – Dermatology Advisor

  https://www.dermatologyadvisor.com/home/decision-support-in-medicine/endocrinology-metabolism/hypopituitarism-2/

  Traumatic brain injury (TBI) may lead to hypothalamic hormone deficiencies as well as central DI. Hormone deficiencies may improve within a few months after trauma, while other hormone deficiencies may develop within the first year after trauma. Growth hormone deficiency is the most common deficiency and has been linked to mild repetitive head trauma as well as a single head trauma leading to severe TBI. […] Patients should have at least annual evaluation by an endocrinologist experienced in managing hypopituitarism with both clinical and laboratory assessment of the adequacy of current hormone replacements and for complications associated with hypopituitarism or of over-replacement of hormones. Patients with known sellar mass lesions should have periodic imaging of the sella, preferably with contrast enhanced MRI.

• #2 Hypopituitarism | Concise Medical Knowledge

  https://www.lecturio.com/concepts/hypopituitarism/

  Hypopituitarism is the condition resulting from inadequate production of pituitary hormones: […] 200,000 people affected in the United States […] Average yearly incidence rate of 4.21 cases per 100,000 […] No difference in incidence between sexes.

• #2 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Hypopituitarism-Epidemiology.aspx

  Hypopituitarism is considered to be a rare disorder. There are less than 200,000 patients with hypopituitarism in the United States. […] On a global basis, the incidence is estimated to be 4.2 cases per 100,000 per year, and the prevalence is approximately 45.5 cases per 100 000 people. These figures are indicative of the general population and have not been adjusted for gender or specific groups at risk. […] It is generally accepted that some population groups are at an increased risk of permanent pituitary deficiency and hypopituitarism. This includes individuals that have a history of traumatic brain injury or aneurysmal subarachnoid hemorrhage. However, the incidence of the condition in these populations remains to be determined, as there is insufficient research to estimate epidemiological parameters.

• #2 Prevalence and incidence of hypopituitarism in an adult Caucasian population in northwestern Spain – PubMed

  https://pubmed.ncbi.nlm.nih.gov/11895214/

  Objective: To determine the prevalence and incidence of hypopituitarism in the general population. […] The study population comprised an average population sample of 146,000 adult inhabitants in South Galicia (northwestern Spain). The Medical Register of the General Hospital of Vigo ensured virtually complete case ascertainment for diagnosed hypopituitarism in this sample population. […] In the first survey the prevalence of hypopituitarism was 29/100,000 (CI, 19.88-37.72), without sex differences. In the second survey, the prevalence observed was higher than in the first, 45.5/100,000 (CI, 34.92-56.08). […] In the longitudinal study with a population of 1,020,764 people-years of observation, the average annual incidence rate of hypopituitarism was 4.21 cases/100,000 (CI, 2.95-5.47), with this incidence being similar for both sexes. The annual incidence of hypopituitarism remained stable during the study period. […] We present for the first time data on the prevalence and incidence of hypopituitarism in the general adult population.

• #2 Hypopituitarism epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Hypopituitarism_epidemiology_and_demographics

  In a longitudinal survey (1992-1999), the incidence of hypopituitarism was estimated to be 4.2 cases per 100,000. A study comprising two cross-sectional surveys showed the prevalence of hypopituitarism to be 29 – 45.5 per 100.000 individual. […] There is one study performed in northern Spain, regarding hypopituitarism epidemiology combining two cross-sectional surveys (from 1992 and 1999). […] In a longitudinal survey (1992-1999), the incidence of hypopituitarism was estimated to be 4.2 cases per 100,000. […] The prevalence of hypopituitarism was found to be 29 – 45.5 per 100,000 individual in the two cross-sectional studies. […] Men and women are affected equally by hypopituitarism. […] Hypopituitarism occurs at any age. […] There is no racial predilection for hypopituitarism.

• #2 Hypopituitarism – Wikipedia

  https://en.wikipedia.org/wiki/Hypopituitarism

  There is only one study that has measured the prevalence (total number of cases in a population) and incidence (annual number of new cases) of hypopituitarism. This study was conducted in Northern Spain and used hospital records in a well-defined population. The study showed that 45.5 people out of 100,000 had been diagnosed with hypopituitarism, with 4.2 new cases per year. 61% were due to tumors of the pituitary gland, 9% due to other types of lesions, and 19% due to other causes; in 11% no cause could be identified. […] Recent studies have shown that people with a previous traumatic brain injury, spontaneous subarachnoid hemorrhage (a type of stroke) or radiation therapy involving the head have a higher risk of hypopituitarism. After traumatic brain injury, as much as a quarter have persistent pituitary hormone deficiencies. Many of these people may have subtle or non-specific symptoms that are not linked to pituitary problems but attributed to their previous condition. It is therefore possible that many cases of hypopituitarism remain undiagnosed, and that the annual incidence would rise to 31 per 100,000 annually if people from these risk groups were to be tested.

• #2 Hypopituitarism (Panhypopituitarism): Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/122287-overview

  A systematic review of 13 observational studies found an estimated prevalence of 27.5% for chronic phase anterior hypopituitarism following TBI. […] A study by Claessen et al found that out of 133 female athletes with a history of one or more mild TBIs, 66.2% demonstrated pituitary hormone screening blood test results outside the reference values, signaling possible hypopituitarism. […] Hypopituitarism may also develop following intracranial bleeding, particularly in cases of aneurysmal subarachnoid hemorrhage (SAH). A systematic review found the pooled prevalence of hypopituitarism following aneurysmal SAH to be 31% at 3-6 months and 25% at over 6 months.

• #2

  https://discovery.ucl.ac.uk/id/eprint/10123537/

  EPIDEMIOLOGY: The incidence is 1 in 4,0001 in 10,000. The majority of CH cases are sporadic; however, a small number of familial cases have been identified. In the latter, a molecular basis has frequently been identified. Between 8090% of CH cases remain unsolved in terms of molecular genetics. […] This review aims to give an overview of CH including management of this complex condition.

• #2 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Hypopituitarism-Epidemiology.aspx

  Other risk factors, such as age, gender, ethnic origin and geographical location, have not yet been identified and there are no clear trends in the incidence or prevalence of hypopituitarism. […] The first scientific study to investigate the prevalence and incidence of hypopituitarism was carried out by Regal et al in Spain with a sample population size of 146 000. In this group of people, the prevalence of hypopituitarism was found to be 45.5 cases per 100,000. […] The standardized mortality rate was 8.05, which is eight times higher than in the general population. It was highest in young males. However, reduced survival rates were recognized to be also related to other coexisting or concurrent factors such as cancer, a history of radiotherapy, a high BMI, acromegaly and diabetes mellitus not under control. Further research is required to support these findings.

• #2

  https://link.springer.com/article/10.1007/s11154-024-09888-8

  In fact, a large population-based, propensity score-matched cohort study of patients with hypopituitarism hospitalized for acute medical conditions recently demonstrated that hypopituitarism was independently associated with increased in-hospital mortality with an odds ratio (OR) of 1.32 (95% CI, 1.061.65). […] The increased mortality was primarily seen in individuals with concomitant AVP deficiency (OR 3.27; 95% CI, 2.224.83), whereas it was not increased in individuals with hypopituitarism without posterior pituitary deficiency (OR 0.78; 95% CI, 0.601.03). […] A recent population-based study of hospitalized patients with secondary AI and propensity-matched controls from the general population showed that secondary AI was associated with significantly higher rates of ICU admission and intubation as well as a prolonged length-of-hospital stay by approximately 3.3 days (95% CI, 2.823.71). […] Furthermore, patients with secondary AI had an approximately 45% increased relative risk of hospital readmission even up to one year after the index hospitalization, highlighting the high burden of disease associated with secondary AI.

• #3 Prevalence and incidence of hypopituitarism in an adult Caucasian population in northwestern Spain – PubMed

  https://pubmed.ncbi.nlm.nih.gov/11895214/

  Objective: To determine the prevalence and incidence of hypopituitarism in the general population. […] The study population comprised an average population sample of 146,000 adult inhabitants in South Galicia (northwestern Spain). The Medical Register of the General Hospital of Vigo ensured virtually complete case ascertainment for diagnosed hypopituitarism in this sample population. […] In the first survey the prevalence of hypopituitarism was 29/100,000 (CI, 19.88-37.72), without sex differences. In the second survey, the prevalence observed was higher than in the first, 45.5/100,000 (CI, 34.92-56.08). […] In the longitudinal study with a population of 1,020,764 people-years of observation, the average annual incidence rate of hypopituitarism was 4.21 cases/100,000 (CI, 2.95-5.47), with this incidence being similar for both sexes. The annual incidence of hypopituitarism remained stable during the study period. […] We present for the first time data on the prevalence and incidence of hypopituitarism in the general adult population.

• #3 SciELO Brazil – Management of hypopituitarism: a perspective from the Brazilian Society of Endocrinology and Metabolism Management of hypopituitarism: a perspective from the Brazilian Society of Endocrinology and Metabolism

  https://www.scielo.br/j/aem/a/YmWnbJ9K4qjG3S7twVCLx3z/

  Hypopituitarism is a heterogeneous disease characterized by insufficient secretion of one or more pituitary hormones due to genetic or acquired causes. The only available epidemiological data estimating the frequency of hypopituitarism in the adult population derived from a Spanish study published in 2001 showing a prevalence of 455 cases per million inhabitants and an incidence of 42.1 cases per million inhabitants per year. If we consider these numbers to be true for our population, Brazil has approximately 100,000 patients with hypopituitarism and roughly 8,500 new cases per year. However, these numbers certainly underestimate the frequency of hypopituitarism, which has increased over the last years due to recognition of new etiologies, such as cerebral hemorrhage and head trauma, emergence of new etiologies, such as drug-induced hypophysitis, and improvements in diagnostic tools. Hypopituitarism has been associated with increased mortality, particularly due to cardiovascular and cerebrovascular diseases. Two recent meta-analyses involving observational studies have confirmed such increased mortality, with higher rates observed especially in women and in patients of younger age at diagnosis. Nevertheless, new concepts in the pathophysiology of hormonal deficiencies, recent advances in diagnostic tools, and the emergence of new formulations for hormone replacement have significantly contributed to a reduction in morbidity and mortality rates in these patients.

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