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15th September 2024
Causes of hypopituitarism
Hypopituitarism refers to the partial or complete deficiency of one or more hormones produced by the pituitary gland. It can result from a combination of these hormone deficiencies, which may be caused by primary pituitary disease or hypothalamic disorders that disrupt hypothalamic control of the pituitary.
| Congenital | Isolated pituitary hormone deficiency | Receptor mutation: GHRH, CRH, GnRH, TRH receptor mutations Hormone mutations (TSHβ, POMC) Prader-Willi syndrome Kallmann syndrome |
| Multiple pituitary hormone deficiency | Transcription factor defects: HESX1, SOX 2/3, LHX3/4, PROP1 Prohormone convertase enzyme mutation: PC1 |
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| Neoplastic | Pituitary adenoma | Functioning and non-functioning adenoma (NFA) |
| Peri-pituitary tumours | Parasellar lesion: craniopharyngioma, Rathke’s cleft cyst Non-adenomatous neoplasm: meningioma, glioma, germ cell tumour Metastases, especially breast, renal, bronchus |
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| Vascular | Infarction/ haemorrhage | Sheehan’s syndrome Pituitary apoplexy Aneurysms |
| Inflammatory / Infiltrative / Immunological |
Hypophysitis: lymphocytic, granulomatous, xanthomatous, necrotising, IgG4-related, immunotherapy-induced (CTLA-4 inhibitors) Haemochromatosis Sarcoidosis Granulomatosis with polyangiitis |
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| Infectious | Bacterial: tuberculosis, syphilis, leptospirosis Fungal: candidiasis, aspergillosis Viral: herpes/varicella infection, SARS-CoV-2 virus |
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| Miscellaneous | Empty sella Traumatic brain injury MedicationsPost-irradiation therapy |
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