Materiały źródłowe

• #1 Hypopituitarism – StatPearls – NCBI Bookshelf

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

  Hypopituitarism can originate from 2 primary sources: pathology of the hypothalamus, which affects the production of tropic hormones that act on the pituitary, or direct pathology within the pituitary gland itself. The predominant cause of hypopituitarism is pituitary tumors, which account for 61% of cases. These tumors may cause overproduction of a single hormone, leading to a deficiency in other pituitary hormones. For instance, in acromegaly, an excess of GH coincides with hypopituitarism due to macroadenoma. […] Most pituitary tumors are benign and can be either secretory or nonsecretory. In rare cases, secondary metastases from breast, colon, and prostate cancers can also impact the pituitary gland. Hypopituitarism can also be associated with hypothalamic and para-pituitary tumors, such as suprasellar meningiomas, gliomas, and craniopharyngiomas. In addition to tumors, various injuries to the pituitary gland, such as traumatic brain injury, iatrogenic injury during surgery, or cranial irradiation, may also cause hypopituitarism.

• #1 Hypopituitarism – StatPearls – NCBI Bookshelf

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

  Infiltrative diseases such as hemochromatosis, sarcoidosis, and histiocytosis have been associated with hypopituitarism development. In these conditions, abnormal deposition of substances or immune-related processes can cause damage and dysfunction of the pituitary gland, ultimately leading to hypopituitarism. […] Hypopituitarism induced by traumatic brain injury is one of the more recently recognized mechanisms that can result in isolated or global pituitary deficits. Some studies indicate worse outcomes and minimal recovery in such cases. […] Pituitary apoplexy is a medical emergency that arises from acute ischemic infarction or hemorrhage within the pituitary gland. […] Congenital absence of the pituitary gland is related to midline craniofacial defects. Genetic mutations in transcription factors, such as HESX1, PROP1, and Pit-1, can lead to congenital hypopituitarism.

• #1 Hypopituitarism – StatPearls – NCBI Bookshelf

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

  Inflammatory conditions that affect the pituitary gland may also contribute to the development of hypopituitarism. Infectious agents associated with pituitary insufficiency include Mycobacterium tuberculosis and agents that don’t belong to the genus Mycobacterium, such as histoplasmosis, syphilis, viruses, and protozoa. […] Lymphocytic hypophysitis is a specific inflammatory condition often observed in the postpartum period. This condition responds well to steroid therapy and manifests as a mass lesion on magnetic resonance imaging (MRI) due to the infiltration of lymphocytes and plasma cells within the pituitary. […] The latest immunotherapy category involving immune checkpoint inhibitors, including cytotoxic T-lymphocytes antigen-4 (CTLA-4), programmed cell death 1 (PD-1), and programmed cell death ligand 1 (PDL-1), can cause hypophysitis. This condition is characterized by central adrenal insufficiency. On rare occasions, it may lead to central hypothyroidism or hypogonadism.

• #1 Hypopituitarism – StatPearls – NCBI Bookshelf

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

  Empty Sella syndrome is a rare disorder characterized by the enlargement or malformation of the sella turcica, resulting in a herniation of the arachnoid membrane into the pituitary fossa. […] Kallmann syndrome is another rare genetic condition characterized by an inability to detect odor, also referred to as hyposmia or anosmia, and hypogonadotropic hypogonadism, marked by decreased FSH, LH, testosterone, or estradiol levels. This syndrome results from a mutation in the Kal1 gene, which is the most frequently observed genetic abnormality in males affected by this condition.

• #2 Etiology of Hypopituitarism in Adult Patients: The Experience of a Single Center Database in the Serbian Population

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5494080/

  There are only a few published studies related to the population-based etiology of hypopituitarism. […] New risks for developing hypopituitarism have been recognized in the last 10 years. […] The most common causes of hypopituitarism in our database are pituitary adenomas. […] Increased awareness of the other causes of pituitary dysfunction, such as congenital, head trauma, extrapituitary cranial irradiation, and infections, is the reason for a higher frequency of these etiologies of hypopituitarism in the presented database. […] Hypopituitarism is defined as the partial or complete loss of anterior pituitary function that can result from acquired or congenital causes. […] According to previous large surveillance databases, hypothalamo/pituitary tumors and their attendant treatments, including surgery and radiotherapy, account for approximately 70% of the acquired causes of pituitary insufficiency.

• #2 Etiology of Hypopituitarism in Adult Patients: The Experience of a Single Center Database in the Serbian Population

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5494080/

  However, with increasing knowledge about the etiology of hypopituitarism, nontumoral causes are becoming more evident. […] Traumatic brain injury-TBI, subarachnoid hemorrhage, and extrapituitary cranial irradiation have also been recognized as the causes of hypopituitarism in the last decade. […] The recognition of infectious/inflammatory diseases as the important causes of hypopituitarism has increased in the recent years. […] The importance of early diagnosis of these rare alternative etiologies of hypopituitarism has been emphasized. […] The higher frequency of patients with traumatic brain injury, SAH, or cranial irradiation in our database is a consequence of our specific interests in these causes of hypopituitarism during the last decade. […] The etiology of hypopituitarism can largely vary between different countries. […] There is a noticeable difference in the prevalence of certain causes of hypopituitarism today compared to a few decades ago.

• #3 Causes of hypopituitarism – UpToDate

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

  Causes of hypopituitarism […] The causes of hypopituitarism will be reviewed here. […] 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.

• #4 Hypopituitarism: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22102-hypopituitarism

  Hypopituitarism is a rare condition in which there’s a deficiency of one, multiple or all of the hormones made by your pituitary gland. It happens when there’s a disorder or damage to your pituitary gland or hypothalamus. […] The condition can happen suddenly after an injury or develop slowly over months or years. […] There are three kinds of hypopituitarism based on its cause and how it affects your pituitary gland or hormones: Primary hypopituitarism: Damage to or disorders of your pituitary gland. […] Secondary hypopituitarism: Damage to or disorders of your hypothalamus. […] Many conditions and situations can cause hypopituitarism. In some cases, healthcare providers can’t determine the cause. In general, these three main factors can cause the condition: Something is putting pressure on (compressing) your pituitary gland or hypothalamus.

• #5 An Update on Advances in Hypopituitarism: Etiology, Diagnosis, and Current Management

  https://www.mdpi.com/2077-0383/13/20/6161

  A variety of hypothalamic lesions may affect the secretion of one or more of the hypothalamic hormones that regulate the pituitary hormones. […] The mechanisms by which a pituitary tumor can cause HP are as follows: (1) direct compression of normal pituitary tissue, damaging pituitary cells and reducing their ability to produce hormones; (2) interference with blood supply by tumor compression of blood vessels supplying the pituitary; (3) local inflammation and mass effect, causing edema and changes in the pituitary microenvironment, disrupting normal pituitary function; and (4) damage to hypothalamic–pituitary pathways, disrupting hormonal signaling from the hypothalamus to the pituitary. […] The largest series of patients analyzing the etiology of HP was conducted in a Turkish population, involving 773 patients from multiple tertiary care institutions.

• #5 An Update on Advances in Hypopituitarism: Etiology, Diagnosis, and Current Management

  https://www.mdpi.com/2077-0383/13/20/6161

  It is important to consider the size and histologic type of pituitary tumors when evaluating the possibility of an associated HP. […] HP is very common in patients with craniopharyngioma, with high rates observed preoperatively and potentially exacerbated postoperatively, affecting quality of life, morbidity, and mortality in these patients. […] Pituitary surgery may result in HP due to the removal of normal peritumoral pituitary tissue. […] Radiation used to treat PitNETs, head and neck tumors, intracranial neoplasms, or as adjuvant cranial irradiation for acute lymphoblastic leukemia can cause HP through several mechanisms, including (1) direct damage to pituitary cells; (2) disruption of the pituitary vasculature; (3) hypothalamic dysfunction; and (4) chronic and progressive processes of cellular and vascular damage.

• #5 An Update on Advances in Hypopituitarism: Etiology, Diagnosis, and Current Management

  https://www.mdpi.com/2077-0383/13/20/6161

  Autoimmune HP-associated diseases include lymphocytic hypophysitis, immune checkpoint inhibitor (ICI)-induced hypophysitis, IgG4-related hypophysitis, and paraneoplastic autoimmune hypophysitis. […] Defects in the embryonic development of the pituitary gland can result in HP. […] Several hormone mutations, transcription factor defects, and hormone receptor mutations can result in isolated hormone deficiencies. […] A number of genetic hypothalamic disorders are associated with HP due to abnormalities in the development and function of the hypothalamus and, consequently, in the production of anterior pituitary hormones. […] Post-traumatic HP is a well-recognized clinical consequence of TBI. […] Systemic infiltrative diseases are a group of relatively rare diseases that involve the deposition of substances or cells in multiple organs, including the endocrine glands.

• #5 An Update on Advances in Hypopituitarism: Etiology, Diagnosis, and Current Management

  https://www.mdpi.com/2077-0383/13/20/6161

  Hypopituitarism (HP), or pituitary insufficiency, is a clinical syndrome that develops as a result of hyposecretion of one or more hormones from the anterior pituitary, with or without involvement of the posterior pituitary. […] The various etiologies are reviewed, including pituitary neuroendocrine tumors (PitNETs), hypothalamic lesions, genetic mutations, and acquired factors such as head trauma, medications, neoplasms, and infiltrative diseases. […] In adults, HP due to pituitary neuroendocrine tumors (PitNETs) or their treatment accounts for approximately half of the cases (49.9%), while non-tumor etiologies and non-PitNET tumors are less common, at 42.3% and 7.7%, respectively. […] In children, PitNETs are rare, and the main causes of HP are congenital diseases due to abnormal pituitary development, genetic mutations (such as PROP1 and PIT1), chromosomal abnormalities such as deletions in chromosome 18, and acquired factors such as tumors (mainly tumors related to alterations in embryogenesis such as craniopharyngiomas and dysgerminomas) or cranial irradiation.

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

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

  Causes of hypopituitarism include pituitary adenomas or other intrasellar and parasellar tumors, inflammatory and infectious destruction, surgical removal, radiation-induced destruction of pituitary tissue, traumatic brain injury (TBI), subarachnoid hemorrhage, and postpartum pituitary infarction (Sheehan syndrome). […] Pituitary tumors, or adenomas, are the most common cause of hypopituitarism in adults, although traumatic brain injury as a cause is being more frequently recognized. […] Hypopituitarism resulting from pituitary adenomas is due to impaired blood flow to the normal tissue, compression of normal tissue, or interference with the delivery of hypothalamic hormones via the hypothalamus-hypophysial portal system. […] In primary pituitary destruction, the anterior pituitary is destroyed, causing a deficiency in some or all pituitary hormones, including prolactin.

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

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

  Head trauma from a motor vehicle accident, a fall, or a projectile can cause hypopituitarism by direct damage to the pituitary or by injuring the pituitary stalk or the hypothalamus. […] Other causes of hypopituitarism include empty sella syndrome and infiltrative diseases. […] Physiologic states can influence the hypothalamus by impairing synthesis and secretion of regulating hormones. […] The degree of hormone deficiency varies greatly and depends on the extent of the process and its location. […] Hypopituitarism can occur in adult patients after cranial radiotherapy performed to treat nonpituitary tumors. […] Additional causes of hypopituitarism include histiocytosis X, hemochromatosis, tuberculosis, syphilis, meningitis, iatrogenic causes, Kallmann syndrome, lymphocytic hypophysitis, transsphenoidal adenomectomy, congenital causes, and immune checkpoint inhibitor-induced hypophysitis. […] In a study of 435 patients, Fatemi et al found evidence that the likelihood of hypopituitarism development after transsphenoidal adenoma removal is higher when the tumor is larger than 20 mm.

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

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

  Disease involving the hypothalamus or pituitary stalk may cause pituitary hormone deficiency with an elevated serum prolactin. […] Hypothalamic disease involves destruction of the hypothalamus. This causes a deficiency or loss of hypothalamic regulatory hormone input to the pituitary, which leads to the loss of anterior pituitary hormone secretion, with an elevated serum prolactin level. […] Longstanding target gland hyposecretion may result in hyperplasia of the relevant pituitary cell secreting the trophic hormone, the level of which would be elevated. […] Another common intracranial tumor is craniopharyngioma, a squamous cell tumor that arises from remnants of the Rathke pouch. […] Sheehan syndrome occurs with a large volume of postpartum hemorrhage. […] Pituitary apoplexy denotes the sudden destruction of the pituitary tissue resulting from infarction or hemorrhage into the pituitary.

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

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

  Causes of hypopituitarism can be divided into categories of congenital and acquired causes. An overview of causes based on categories is summarized below. […] Congenital causes of hypopituitarism include the following: Perinatal insults (eg, traumatic delivery, birth asphyxia), Interrupted pituitary stalk, Absent or ectopic neurohypophysis, Pallister-Hall syndrome (Hypothalamic hamartoma and polydactyly). […] Cranial irradiation and hemochromatosis can lead to hypopituitarism. Delayed presentation of pituitary hormone deficiencies from radiation-induced damage resulting from therapy for CNS and non-CNS tumors has received increased recognition. […] Infiltrative disorders that can cause hypopituitarism include the following: Histiocytosis X, Tuberculosis, Sarcoidosis, Lymphocytic hypophysitis. […] Tumors (eg, sellar, suprasellar, pineal) that can result in hypopituitarism include the following: Craniopharyngioma, Germinoma, Glioma/astrocytoma, Pituitary adenoma (rare prior to adulthood).

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

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

  Hypopituitarism has multiple possible etiologies either from congenital or acquired mechanisms. The common endpoint is disrupted synthesis or release of 1 or more pituitary hormones, resulting in clinical manifestations of hypopituitarism. […] Genetic causes of hypopituitarism are relatively rare. However, research since the late 20th century has brought considerable advances in the understanding of the various genetic causes of congenital hypopituitarism. Inheritance patterns may be autosomal recessive, autosomal dominant, or X-linked recessive. The phenotype and severity of clinical findings in congenital hypopituitarism are determined by the specific genetic mutation. […] Mutations in pituitary transcription factors can cause multiple pituitary hormone deficiencies (MPHD) or, less commonly, an isolated pituitary hormone deficiency. Mutations in PIT1 (POUF1) and PROP1 (ie, prophet of Pit-1) were the first mutations shown to cause MPHD.

• #8 Hypopituitarism – Hormonal and Metabolic Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/pituitary-gland-disorders/hypopituitarism

  Hypopituitarism is an uncommon disorder. It can be caused by a number of factors, including certain inflammatory disorders, a pituitary tumor, or an insufficient blood supply to the pituitary gland. […] Causes affecting primarily the pituitary include pituitary tumors, inadequate blood supply to the pituitary (due to severe bleeding, blood clots, anemia, or other conditions), infections, inflammatory disorders (such as sarcoidosis), inflammation of the pituitary due to anticancer monoclonal antibody medications, irradiation (as for a brain tumor), surgical removal of pituitary tissue, autoimmune disorders, and surgical damage to the pituitary or to the blood vessels or nerves leading to it. […] Causes affecting primarily the hypothalamus include tumors of the hypothalamus, inflammatory disorders, head injuries, and deficiencies of hypothalamic hormones.

• #9 Hypopituitarism: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22102-hypopituitarism

  There’s damage to your pituitary gland or hypothalamus. […] You have a rare condition or a condition that causes hypopituitarism. […] Conditions that can cause pressure on these areas of your brain, possibly leading to hypopituitarism, include: Pituitary adenomas: A benign tumor on your pituitary gland that can change the way it releases hormones. […] Brain tumors: A brain tumor near your hypothalamus and/or pituitary gland can affect hormone production. […] Examples of situations that can cause pituitary or hypothalamus damage include: Surgery: Complications from brain surgery (especially surgery to remove a pituitary adenoma). […] Radiation therapy: Prior cancer radiation therapy or radiation used to treat a pituitary adenoma. […] Examples of rare conditions that can cause the condition include: Hereditary hemochromatosis: This genetic condition causes too much iron in your bloodstream. It can damage your pituitary gland. […] Bacterial meningitis: Although it’s rare, hypopituitarism can be a complication of bacterial meningitis.

• #10 Azthena logo with the word Azthena

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

  There are various causes of hypopituitarism, including both inherited and acquired causes. The most common cause is a pituitary adenoma. Other identified causes include: […] The most common cause of hypopituitarism is a pituitary adenoma, a tumor in the pituitary gland. […] Other tumors of the brain which arise in close proximity to the pituitary gland may also cause the condition, including craniopharyngiomas and Rathkes cleft cysts. […] Severe head trauma or injuries can lead to a range of neurological symptoms, as well as those of hypopituitarism. […] Individuals who have undergone brain surgery in the pituitary region are more likely to be affected by hypopituitarism. […] Radiation therapy that is directed towards a pituitary tumor or the entire brain can also affect the function of the pituitary gland, leading to a reduction in the production of pituitary hormones.

• #10 Azthena logo with the word Azthena

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

  Genetic mutations that impair the production of pituitary hormones may also be responsible for causing hypopituitarism. […] Infiltrative diseases that cause inflammation such as sarcoidosis, Langerhans cell histiocytosis and hemochromatosis can also cause hypopituitarism in some patients. […] Pituitary apoplexy refers to infarction or hemorrhage into the pituitary gland. […] For some patients with hypopituitarism, the cause of the condition cannot be identified. This is referred to as idiopathic hypopituitarism. […] Since the pituitary function depends directly on the hypothalamus, any condition which results in altered hypothalamic function will reflect in corresponding hypopituitarism. […] Emotional stress, drastic drop in body weight, eating disorders, habitual over-exercise, congestive cardiac failure, renal failure, and some medicines can also be functional causes of hypopituitarism.

• #11 Hypopituitarism – Pituitary Foundation

  https://www.pituitary.org.uk/information/hypopituitarism/

  Hypopituitarism can involve one or more pituitary hormones. […] There are a large number of causes of hypopituitarism. Most often it is caused by a benign (i.e. not cancerous) tumour of the pituitary gland. […] Pituitary under activity may be caused by the direct pressure of the tumour mass on the normal pituitary, but also may result from surgery or radiotherapy used to treat the tumour. […] Less frequently, hypopituitarism can be caused by tumours in the region surrounding the pituitary gland (i.e. craniopharyngioma, meningioma); cysts within the pituitary gland (i.e. Rathkes cleft cyst); infections (such as meningitis) in or around the brain; inflammation of the pituitary gland (i.e. Hypophysitis, see below); severe blood loss; or by various rare diseases such as sarcoidosis (an illness which resembles tuberculosis). […] Sheehans Syndrome is also known as postpartum hypopituitarism, or postpartum pituitary insufficiency and may occur in a woman who has severe uterine haemorrhage during childbirth. […] Another cause of hypopituitarism that may be associated with pregnancy is lymphocytic hypophysitis.

• #12 Pituitary Failure | Hypopituitarism | Pacific Pituitary Disorders Center

  https://www.pacificneuroscienceinstitute.org/pituitary-disorders/conditions/pituitary-adenomas/pituitary-failure/

  Hypopituitarism refers to under-function of the pituitary gland. The term refers to both anterior and posterior pituitary gland dysfunction. It may be temporary or permanent. Panhypopituitarism refers to complete loss of all pituitary function. […] Loss of pituitary function can result from damage to the pituitary gland, the pituitary stalk or the hypothalamus. The hypothalamus contains releasing and inhibitory hormones that control the pituitary and reach the gland via the pituitary stalk (infundibulum). Injury to the pituitary gland, pituitary stalk or hypothalamus can occur from: A pituitary tumor, Brain tumor, Brain or pituitary surgery, Radiation to the pituitary, Pituitary apoplexy (hemorrhage), Pituitary inflammation (hypophysitis), Autoimmune disorders. […] There appears to be a somewhat predictable loss of hormonal function: the growth hormone (GH), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) secreting cells appear most vulnerable while thyroid stimulating (TSH) and adrenocorticotropic hormone (ACTH) secreting cells are less vulnerable. […] Based on our large surgical experience published in 2008 of over 400 patients treated with endonasal pituitary adenoma removal, gland recovery and loss of function can be reliably predicted.

• #13 Hypopituitarism Causes & Symptoms + 8 Natural Remedies – Dr. Axe

  https://draxe.com/health/hypopituitarism/

  Sheehans syndrome is a condition that affects women who lose a life-threatening amount of blood in childbirth and/or dont have enough oxygen after childbirth. It is one of the most common causes of hypopituitarism in both underdeveloped and developing countries. […] Various studies have also looked into the effects of radiation damage and its link to hypopituitarism. Data shows that with low radiation doses, growth hormone deficiency usually occurs in isolation in about 30 percent of patients. With higher radiation doses (30 to 50 Gy), the incidence of growth hormone deficiency can reach 50 to 100 percent of patients. Researchers have also found that with higher dose cranial irradiation or following conventional irradiation for pituitary tumors, multiple hormonal deficiencies happen in 30 to 60 precent of patients after ten years of follow-up.

• #14 Hypopituitarism – Wikipedia

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

  A pregnancy comes to term, a pregnant woman’s pituitary gland is vulnerable to low blood pressure, such as may result from hemorrhage; pituitary damage due to bleeding after childbirth is called Sheehan’s syndrome. […] Pituitary apoplexy is hemorrhage or infarction of the pituitary. […] Other forms of stroke are increasingly recognized as a cause for hypopituitarism. […] Congenital hypopituitarism may be the result of complications around delivery, or may be the result of insufficient development of the gland, sometimes in the context of specific genetic abnormalities. […] Kallmann syndrome causes deficiency of the gonadotropins only.

• #14 Hypopituitarism – Wikipedia

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

  Hypopituitarism is the decreased (hypo) secretion of one or more of the eight hormones normally produced by the pituitary gland at the base of the brain. […] The diagnosis of hypopituitarism is made by blood tests, but often specific scans and other investigations are needed to find the underlying cause, such as tumors of the pituitary, and the ideal treatment. […] Most cases of hypopituitarism are due to pituitary adenomas compressing the normal tissue in the gland, and rarely other brain tumors outside the gland. […] The pituitary may also be affected by infections of the brain or of the gland itself, or it may be infiltrated by abnormal cells or excessive iron. […] Empty sella syndrome is unexplained disappearance of pituitary tissue, probably due to outside pressure. […] Autoimmune or lymphocytic hypophysitis occurs when the immune system directly attacks the pituitary.

• #15 Hypopituitarism

  https://johnsonmemorial.org/jmh-health/disease-conditions/con-20164003

  Hypopituitarism has a number of causes. One common cause is a tumor of the pituitary gland. As a pituitary tumor grows, it can press on and damage pituitary tissue. This disrupts the pituitary gland’s ability to make hormones. A tumor also can press on the optic nerves, causing vision problems. […] Other potential causes of damage to the pituitary gland that may lead to hypopituitarism include: Lack of blood flow to the brain or pituitary gland, known as a stroke, or bleeding, called hemorrhage, into the brain or pituitary gland. Certain medicines, such as narcotics, high-dose steroids or certain cancer medicines called checkpoint inhibitors. Swelling, known as inflammation, of the pituitary gland caused by an unusual immune system response, called hypophysitis. Infections of the brain, such as meningitis, or infections that can spread to the brain, such as tuberculosis or syphilis. Significant blood loss during childbirth, which can damage the front part of the pituitary gland. This condition is known as Sheehan syndrome or postpartum pituitary necrosis.

• #16 Hypopituitarism Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/hypopituitarism

  Hypopituitarism may be caused by: […] Hypopituitarism is also a rare complication caused by severe bleeding during pregnancy. The loss of blood leads to tissue death in the pituitary gland. This condition is called Sheehan syndrome. […] Sometimes, hypopituitarism is due to uncommon immune system or metabolic diseases, such as: […] Certain medicines can also suppress pituitary function. The most common medicines are glucocorticoids (such as prednisone and dexamethasone), which are taken for inflammatory and immune conditions. Medicines used to treat prostate cancer can also lead to low pituitary function.

• #17 Hypopituitarism in children

  https://www.aboutkidshealth.ca/hypopituitarism-in-children

  Hypopituitarism occurs when the pituitary gland does not produce one or more pituitary hormones, or it does not produce enough hormones. […] Hypopituitarism can be congenital (present at birth) or acquired through damage to the pituitary or hypothalamus. […] In many cases, the cause of hypopituitarism is unknown. However, it is not generally something that is passed on by parents to their children. Hypopituitarism may be: Congenital (meaning present at birth) The pituitary or hypothalamus did not form normally before birth (e.g., septo optic dysplasia). […] Acquired There was damage to the pituitary or hypothalamus during or sometime after birth. […] A tumour in the pituitary area of the brain, a severe head injury, or a brain infection (such as encephalitis) can result in acquired hypopituitarism. Other causes include surgical removal of the pituitary gland, some chemotherapy, or radiation therapy to the part of the brain where the pituitary is located.

• #18 Hypopituitarism – Hypothalamus and Pituitary Diseases – Endocrinology – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.8.3.

  Cranial trauma and iatrogenic: Surgery (most frequently transsphenoidal sellar lesion), severe head trauma/brain injury, pituitary/sellar irradiation. […] Vascular: Postpartum pituitary infarction (due to postpartum hemorrhage [Sheehan syndrome]), pituitary apoplexy (sudden hemorrhage into the pituitary gland), internal carotid artery aneurysm (compression), stroke (ischemic or subarachnoid hemorrhage). […] Inflammatory and infiltrative lesions: Sarcoidosis, hemochromatosis, Langerhans cell histiocytosis, granulomatosis with polyangiitis (formerly Wegeners disease), hypophysitis related to immune checkpoint inhibitors, autoimmune, granulomatous, xanthomatous, or IgG-4 related disease. […] Drug/medication related: Supraphysiologic corticosteroids, high-dose opiates. […] Infections: Tuberculosis, syphilis, mycoses, pituitary abscess, encephalitis, meningitis.

• #18 Hypopituitarism – Hypothalamus and Pituitary Diseases – Endocrinology – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.8.3.

  Hypopituitarism refers to a syndrome caused by deficiency of 1 pituitary hormone, which can result from pituitary or hypothalamic disease (deficiency of pituitary hormonereleasing hormones). […] In general, the acquired loss of pituitary function follows the sequence of growth hormone (GH), luteinizing hormone (LH)/follicle-stimulating hormone (FSH), thyroid-stimulating hormone (TSH), adrenocorticotropic hormone (ACTH), and prolactin with tumors and radiation, but the sequence may vary with other etiologies. […] The most common causes of hypopituitarism are in boldface. […] Tumors: Pituitary adenomas (functioning and nonfunctioning), craniopharyngiomas, posterior pituitary tumors (ganglioneuroma, astrocytoma), hypothalamic tumors (astrocytoma, germinoma), tumors of the skull base/optic chiasm (meningioma, glioma), metastases (most frequently breast and lung cancer).

• #19 Insights into non-classic and emerging causes of hypopituitarism | Nature Reviews Endocrinology

  https://www.nature.com/articles/s41574-020-00437-2

  Genetic causes, traumatic brain injury or aneurysmal subarachnoid haemorrhage, autoimmune and inflammatory diseases, and the use of immune checkpoint inhibitors as antineoplastic agents are all non-classic causes that can be associated with hypopituitarism. […] Data suggest that posterior pituitary damage can affect oxytocin secretion, potentially increasing depression, anxiety and alexithymia, thereby underlining the relationship between behaviour alterations, metabolism and regulation of food intake and pituitary function.

• #19 Insights into non-classic and emerging causes of hypopituitarism | Nature Reviews Endocrinology

  https://www.nature.com/articles/s41574-020-00437-2

  Hypopituitarism is defined as one or more partial or complete pituitary hormone deficiencies, which are related to the anterior and/or posterior gland and can have an onset in childhood or adulthood. The most common aetiology is a sellar or suprasellar lesion, often an adenoma, which causes hypopituitarism due to tumour mass effects, or the effects of surgery and/or radiation therapy. […] However, other clinical conditions, such as traumatic brain injury, and autoimmune and inflammatory diseases, can result in hypopituitarism, and there are also genetic causes of hypopituitarism. Furthermore, the use of immune checkpoint inhibitors to treat cancer is increasing the risk of hypopituitarism, with a pattern of hormone defects that is different from the classic patterns and depends on mechanisms that are specific for each drug.

• #20 Hypopituitarism: Causes, Symptoms, and Treatment

  https://www.healthline.com/health/endocrine-health/hypopituitarism

  Sometimes, for various reasons, your pituitary gland may not produce enough of one or more of these hormones. This is known as hypopituitarism. […] Trauma may cause your pituitary gland to stop producing enough of one or more of its hormones. For example, brain surgery, brain infection, or head injury can affect your pituitary gland. […] Certain tumors can also affect the function of this gland. These include: brain tumors, pituitary gland tumors (a common cause of hypopituitarism), hypothalamus tumors. […] Some other possible causes of hypopituitarism include: Sarcoidosis: This is a chronic lung disease. Hemochromatosis: This is a hereditary disease characterized by too much iron in the body. Histiocytosis X: This is a rare autoimmune disorder in which immune cells attack the organs. Tuberculosis: This is an infectious lung disease. Lymphocytic hypophysitis: This is an autoimmune disease characterized by inflammation of the pituitary gland. Sheehan syndrome: This is blood loss during childbirth. Radiation: This is a type of cancer treatment. Traumatic brain injury: This may cause hypopituitarism in newborns, infants, and children. […] There may also be other causes of hypopituitarism. And in some cases of hypopituitarism, the cause may be unknown.

• #21 Hypopituitarism – Symptoms, Causes, Diagnosis & Treatment

  https://www.metropolisindia.com/blog/preventive-healthcare/hypopituitarism-causes-and-diagnosis

  Hypopituitarism can be caused due to damage or disorders of the hypothalamus or pituitary gland. […] Trauma is one of the most common causes due to which your pituitary gland stops producing appropriate amounts of one or more hormones. Brain infection, brain surgery or a head injury can also affect the working of the pituitary gland. […] Some tumours can also hinder the proper functioning of the pituitary gland. These include: Tumours in the pituitary gland, Tumours in the brain, Tumours in the hypothalamus. […] Other possible causes of hypopituitarism include: Hemochromatosis: A hereditary disease, which leads to the accumulation of iron in the body. Histiocytosis X: A rare autoimmune condition in which the immune cells start attacking the body’s organs. Sarcoidosis: A chronic lung disorder. Tuberculosis: An infectious lung disorder. Sheehan syndrome: Blood loss during childbirth. Traumatic brain injury: Usually causes hypopituitarism in newborns, children and infants. Radiation therapy: A type of cancer treatment. Lymphocytic hypophysitis: An autoimmune disorder, which causes inflammation of the pituitary gland.

• #22 Pituitary Health – Management Of Hypopituitarism

  https://pituitarysociety.org/hypopituitarism/

  Inflammation of the pituitary can also cause hypopituitarism (see Table 1). Sarcoidosis and histiocytosis are types of chronic inflammation that also can result in hypopituitarism. […] Severe head trauma, usually accompanied by coma or other neurologic problems, can also cause hypopituitarism. Approximately 15% of patients with a history of severe head trauma have been found to be GH deficient. Other hormone deficiencies may also occur after severe head trauma.

• #23 Hypopituitarism

  https://mobile.fpnotebook.com/Endo/Pituitary/Hyptrsm.htm

  Decreased or loss of pituitary Hormone secretion due to surgery, radiation, CNS Mass, infarction or Pituitary Apoplexy. […] Causes include Pituitary Adenoma (most common), Sheehan Syndrome, and various hormonal medications. […] Congenital causes include Perinatal Injury, Developmental Disorders, Anencephaly, and Lipid storage disease. […] Genetic causes include PIT-1, PROP-1, HESX1, LHX3, 4, and PITX2. […] Trauma can result from Closed Head Injury, CNS Surgery, or Irradiation to brain, pituitary or nasopharynx. […] Ischemic Pituitary necrosis can occur due to Postpartum Hemorrhage (Sheehan Syndrome), Diabetes Mellitus, Sickle Cell Disease, Temporal Arteritis, or Eclampsia. […] Infectious diseases such as Tuberculous Meningitis, Malaria, HIV Infection, and Fungal Infections can also be causes.

• #23 Hypopituitarism

  https://mobile.fpnotebook.com/Endo/Pituitary/Hyptrsm.htm

  Infiltrative diseases include Hemochromatosis, Amyloidosis, Lipid storage disease, and Granulomatous Disease. […] Miscellaneous primary causes include Primary Empty Sella Syndrome and Monohormonal idiopathic defects. […] Miscellaneous secondary causes include Nutritional Deficiency (Starvation, Anorexia Nervosa).

• #24 Hypopituitarism – Causes, Symptoms, Diagnosis, Treatment and Prevention

  https://www.medindia.net/health/conditions/hypopituitarism.htm

  Hypopituitarism can be caused by a pituitary tumor also known as pituitary adenoma. It is benign and can compress the rest of the pituitary gland and destroy its ability to produce hormones appropriately. […] Radiation therapy for a brain or pituitary tumor can destroy pituitary gland tissue. […] Infiltrative diseases, such as sarcoidosis can destroy the anterior pituitary. Autoimmune diseases such as lymphocytic hypophysitis damage the pituitary gland or its stalk. […] Sometimes gene mutations lead to impaired pituitary hormone production. […] Hypopituitarism can also be caused by diseases of the hypothalamus as the hormones produced by the hypothalamus directly affect the activity of the pituitary. […] Head injury from an accident can also cause hypopituitarism by directly damaging the pituitary or by injuring either the hypothalamus or the pituitary stalk.

• #25 Infectious Causes of Hypopituitarism in Children: A Systematic Review

  https://www.gavinpublishers.com/article/view/infectious-causes-of-hypopituitarism-in-children-a-systematic-review

  Infectious causes of hypopituitarism in children are uncommon and have principally been reported in literature as case series and case reports. Infectious meningitis, encephalitis, and hypophysitis can lead to pituitary hormone deficiency. Mycobacterium tuberculosis is a known causative microorganism. Pituitary abscess is rare but potentially life-threatening. The occurrence of infectious diseases as a cause of pediatric hypopituitarism has not been systematically reviewed yet. […] Causes of acquired hypopituitarism are diverse and include tumors, autoimmune disease, infiltrative disease, chemotherapy, radiation exposure, trauma, and infection. […] Tuberculosis (TBC) of the central nervous system and pituitary abscess were the most frequent etiologies, followed by meningitis and meningoencephalitis with various microorganisms involved.

• #26 Infectious Causes of Hypopituitarism in Children: A Systematic Review

  https://www.gavinpublishers.com/article/view/infectious-causes-of-hypopituitarism-in-children-a-systematic-review

  TBC and pituitary abscess have been most frequently associated with pediatric hypopituitarism. However, the occurrence of pituitary insufficiency in septic children needs to be further quantified. […] Infection is a known cause of hypopituitarism in children as cases have since long been presented. Currently, scarce evidence about this topic is available for clinicians in forms different from case studies. […] This review outlines which infections may be involved when hypopituitarism is detected in a child. Similarly, it provides an overview of the infectious conditions in which the potential risk of pituitary disturbances must be considered. […] Vital organ functions can be compromised, especially in children with active viral, bacterial, or even amebic meningitis or meningoencephalitis. […] Our results demonstrated fever to be present in a minority of children who have pituitary abscess, and this finding is consistent with data from non-pediatric case series. […] Mortality and long-term morbidity are considerable, and make raising awareness among physicians necessary.

• #27

  https://www.archivesofmedicalscience.com/Genetic-causes-of-hypopituitarism,105909,0,2.html

  Hypopituitarism can be due to abnormal gland development as a result of genetic defects, which result from mutations in gene coding for transcription factors which regulate pituitary development. […] The mutations can be divided into those causing isolated hypopituitarism or those causing syndromes with associated hypopituitarism. […] Genetic abnormalities, however, are only identified in 5-10% of those with congenital hypopituitarism, but it is estimated that a further 5-30% of individuals with a first-degree relative with the disorder possess a genetic mutation yet to be identified. […] Mutations in gene coding for growth hormone (GH1) and gene coding the growth hormone releasing hormone receptor (GHRHR) are known to cause idiopathic growth hormone deficiency (IGHD). […] Mutations in various genes which encode transcription factors related to pituitary development have been associated with varying degrees of hypopituitarism.

• #27

  https://www.archivesofmedicalscience.com/Genetic-causes-of-hypopituitarism,105909,0,2.html

  Septo-optic dysplasia, although rare, is the most common congenital cause of hypopituitarism, encompassing any combination of two of the triad: optic nerve hypoplasia, hypopituitarism and midline structural abnormalities. […] Several genetic mutations have been demonstrated to result in various forms of the condition. […] HESX1, a transcriptional repressor, regulates some of the earliest stages of pituitary development. […] SOX2 and -3 are SRY-related HMG box transcription factors may be responsible for maintaining pituitary progenitor cells and their function. […] Mutations in FGF8 and FGFR1 have been found in 10% of patients with Kallmann syndrome and 7% of those with idiopathic hypogonadotropic hypogonadism. […] Despite the identification of an increased number of genetic causes of isolated or multiple pituitary deficiencies it should be appreciated that the etiology of most (80-90%) congenital causes of hypopituitarism remain unsolved.

• #28 Genetic causes of hypopituitarism | ECE2015 | 17th European Congress of Endocrinology | Endocrine Abstracts

  https://www.endocrine-abstracts.org/ea/0037/ea0037s3.2

  Genetic causes of anterior pituitary hormone deficiencies may result in combined or isolated pituitary hormone deficiencies. […] However to date, despite the identification of a growing number of genetic causes of isolated or multiple pituitary deficiencies, the etiology of most (80-90%) congenital cases of hypopituitarism remains unsolved. […] Identifying new etiologies is of importance as a post-natal diagnosis to better diagnose and treat the patients (delayed pituitary deficiencies, differential diagnosis of a pituitary mass on MRI), and as a prenatal diagnosis to decrease the risk of early death (undiagnosed corticotroph deficiency for instance). […] Among more recently identified forms, the DAVID syndrome, an association of a deficit in adrenocorticotrophin with recurrent infections due to variable immunodeficiency was recently associated with NFKB2 mutations. […] In such a context, PROP1 gene mutations remain the most frequently reported genetic defect.

• #29 Hypopituitarism – UF Health

  https://ufhealth.org/conditions-and-treatments/hypopituitarism

  Hypopituitarism may be caused by: […] Sometimes, hypopituitarism is due to uncommon immune system or metabolic diseases, such as: […] Hypopituitarism is also a rare complication caused by severe bleeding during pregnancy. The loss of blood leads to tissue death in the pituitary gland. This condition is called Sheehan syndrome. […] Certain medicines can also suppress pituitary function. The most common medicines are glucocorticoids (such as prednisone and dexamethasone), which are taken for inflammatory and immune conditions. Medicines used to treat prostate cancer can also lead to low pituitary function.

• #30 Hypopituitarism // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/hypopituitarism

  Hypopituitarism has a number of causes. One common cause is a tumor of the pituitary gland. As a pituitary tumor grows, it can press on and damage pituitary tissue. This disrupts the pituitary gland’s ability to make hormones. A tumor also can press on the optic nerves, causing vision problems. […] Other potential causes of damage to the pituitary gland that may lead to hypopituitarism include: […] Lack of blood flow to the brain or pituitary gland, known as a stroke, or bleeding, called hemorrhage, into the brain or pituitary gland. […] Certain medicines, such as narcotics, high-dose steroids or certain cancer medicines called checkpoint inhibitors. […] Swelling, known as inflammation, of the pituitary gland caused by an unusual immune system response, called hypophysitis. […] Infections of the brain, such as meningitis, or infections that can spread to the brain, such as tuberculosis or syphilis.

• #31 Hypopituitarism | Endocrine Society

  https://www.endocrine.org/patient-engagement/endocrine-library/hypopituitarism

  Hypopituitarism can be caused by: […] Sometimes, the cause is unknown (called idiopathic).

• #32 Hypopituitarism in Children | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/hypopituitarism

  Hypopituitarism in children may be caused by: […] A genetic condition that affects the development of either the pituitary gland or the hypothalamus (a part of the brain that sends signals to the pituitary) […] Pituitary tumors or other tumors that infringe on either the pituitary or the hypothalamus […] Radiation to the head […] A head injury […] An infection […] An autoimmune process. […] Hypopituitarism can also be idiopathic, meaning that no exact cause can be determined.

• #33 Diagnosis and Treatment of Hypopituitarism

  https://www.e-enm.org/journal/view.php?doi=10.3803/enm.2015.30.4.443

  Central nervous system disorders involving the hypothalamus, such as craniopharyngioma and germ cell tumor, may also cause hypopituitarism by impeding the secretion of releasing hormone from hypothalamus. […] Recently, the prevalence of idiopathic hypopituitarism has increased but it is thought that these cases are likely due to a severed stalk resulting from traumatic brain injury (TBI) or hypothalamic damage. […] In rare cases, genetic conditions such as Kallmann syndrome or neurohypophyseal diabetes insipidus may contribute to reduced pituitary function.

• #33 Diagnosis and Treatment of Hypopituitarism

  https://www.e-enm.org/journal/view.php?doi=10.3803/enm.2015.30.4.443

  Hypopituitarism is a chronic endocrine illness that caused by varied etiologies. […] Hypopituitarism is defined as the total or partial loss of anterior and posterior pituitary gland function that is caused by pituitary or hypothalamic disorders. […] A variety of diseases may cause hypopituitarism and, accordingly, this disorder can be divided into two types depending on its cause. Primary hypopituitarism is caused by disorders of the pituitary gland itself and may be due to the loss, damage, or dysfunction of pituitary hormone-secreting cells. On the other hand, secondary hypopituitarism is the result of diseases of the hypothalamus or pituitary stalk interrupting the nerve or vascular connections to the pituitary gland, thereby reducing the secretion of the pituitary hormones. […] The most common causes of primary hypopituitarism are pituitary adenoma and complications from surgery or radiation therapy for the treatment of pituitary adenoma.

• #33 Diagnosis and Treatment of Hypopituitarism

  https://www.e-enm.org/journal/view.php?doi=10.3803/enm.2015.30.4.443

  Several putative mechanisms of hormone deficiency include the application of direct pressure onto or damage to the normal tissues surrounding the tumor, mechanical compression of the portal veins by the pituitary stalk, raised intrasellar pressure, and focal necrosis due to the prolonged portal vein interruption. […] Inflammatory hypophysitis (including various types of autoimmune hypophysitis), which has an unknown etiology and presents with symptoms that are difficult to differentiate from those associated with a tumor, is another possible cause of hypopituitarism. […] Radiation exposure for the treatment of malignant conditions in the head and neck area may also cause hypopituitarism. […] Damage to the pituitary stalk often occurs after the head and/or neck injury accompanying a fracture of the bones surrounding the sella turcica.

• #34 Generalized Hypopituitarism – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/pituitary-disorders/generalized-hypopituitarism

  Hypopituitarism is divided into […] The different causes of primary and secondary hypopituitarism are listed in the table Causes of Hypopituitarism. […] Causes primarily affecting the pituitary gland (primary hypopituitarism) […] Causes primarily affecting the hypothalamus (secondary hypopituitarism)

• #35 Hypopituitarism | Pituitary Network Association – International non-profit organization for patients with pituitary tumors and disorders

  https://pituitary.org/disorders/hypopituitarism/

  Hypopituitarism is a general term that refers to any under function of the pituitary gland. This is a clinical definition used by endocrinologists and is interpreted to mean that one or more functions of the pituitary are deficient. The term may refer to both anterior and posterior pituitary gland failure. […] Deficient pituitary gland function can result from damage to either the pituitary or the area just above the pituitary, the hypothalamus. The hypothalamus contains releasing and inhibitory hormones which control the pituitary. Since these hormones are necessary for normal pituitary function, damage to the hypothalamus can also result in deficient pituitary gland function. Injury to the pituitary can occur from a variety of insults, including damage from an enlarging pituitary tumor, irradiation to the pituitary, pituitary apoplexy, trauma and abnormal iron storage (hemochromatosis). With increasing damage there is a progressive decrease in function. There appears to be a predictable loss of hormonal function with increasing damage. The progression from most vulnerable to least vulnerable is usually as follows: first is growth hormone (GH), next the gonadotropins (LH and FSH which control sexual/reproductive function), followed by TSH (which control thyroid hormone release) and finally the last to be lost is typically ACTH (which controls adrenal function). […] Sheehans syndrome is a condition that may occur in a woman who has a severe uterine hemorrhage during childbirth. The resulting severe blood loss causes tissue death in her pituitary gland and leads to hypopituitarism following the birth.

• #36 Hypopituitarism Treatment & Causes | Lurie Children’s

  https://www.luriechildrens.org/en/specialties-conditions/hypopituitarism/

  In children, hypopituitarism is usually caused by something congenital (the child is born with the problem) or by a pituitary tumor. The tumor interferes with the gland. Sometimes, the cause cannot be determined. […] Sometimes, the cause was present before the child was born. Often, we see that the pituitary gland is under-developed. A genetic error may be the reason the gland doesn’t work well. […] A tumor can cause hypopituitarism. The tumor may grow in the pituitary gland or outside the gland, compressing the normal tissue. […] Rarely, one of these conditions leads to this hormone problem: An infection in the brain, A traumatic brain injury, Radiation to the brain, Bleeding into the pituitary gland.

• #37 Hypopituitarism | Riley Children’s Health

  https://www.rileychildrens.org/health-info/hypopituitarism

  Hypopituitarism occurs when the pituitary gland does not make some or all of these hormones. […] Hypopituitarism may be congenital (present at birth) or acquired (developed later in life). Congenital hypopituitarism is caused by a missing, underdeveloped or incorrectly located pituitary gland. Acquired hypopituitarism is often caused by damage to the pituitary gland. Conditions that may damage the pituitary gland include brain infection, brain hemorrhage, head trauma, stroke or a tumor in the brain, pituitary gland or hypothalamus. Brain surgery or radiation treatment may also cause damage to the pituitary gland.

• #38 Hypopituitarism: recognising new causes and reducing complications | Endocrinology Today

  https://endocrinology.medicinetoday.com.au/et/2015/april/feature-article/hypopituitarism-recognising-new-causes-and-reducing-complications

  Hypopituitarism is becoming more common because of increasing recognition of novel causes of this condition. […] Pituitary adenoma is the most common cause of hypopituitarism; however, immune-modulating therapy for metastatic melanoma is an increasingly recognised cause of autoimmune hypophysitis, particularly in Australia.

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