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Hypopituitarism - Coggle Diagram
Hypopituitarism
Causes
Tumours - Pituitary Adenoma, Cerebral Tumours, Craniopharyngioma
Vascular Disease - Sheehan's Syndrome, Pituitary Apoplexy
Inflammatory Disease - Sarcoidosis, Haemochromatosis
Trauma - Head Injury
Infection - Meningitis, Abscess
Iatrogenic - Surgery, GC, Skull Irradiation
Congenital - Kallmann's Syndrome
Empty Sella Syndrome (RARE)
Hypothalamic Disease - Anorexia Nervosa, Infection
Clinical Manifestation
Prolactin
Failure of Postpartum Lactation
GH
Growth Failure (Dwarfism), Muscle Wasting & Weakness, Hypoglycaemia, Osteopenia, Impaired Psychological Well-Being
LH & FSH
Amenorrhea/Oligomenorrhea, Infertility, Breast & Genitalia Atrophy, Decreased Libido, Impotence, Loss of Pubic/Axillary Hair
ACTH
Hypoadrenalism (Weakness, Weight Loss, Postural Hypotension, Low Na+, Hypoglycaemia, Pallor, N&V, Amenorrhea, Decreased Libido)
Pallor (Low ACTH (from POMC) --> Loss of MSH --> Low Melanin Synthesis --> Hypopigmentation)
TSH
Hypothyroidism (Constipation, Dry Skin, Fatigue, Weakness, Weight Gain, Cold Intolerance)
ADH
Diabetes Insipidus
Polydipsia & Polyuria
Reduced Permeability of Collecting Ducts to Water --> Inability to Resorb Water Properly --> Increased Free Water Excretion --> Polyuria (Dilute Urine) --> Activation of Thirst Centre in Hypothalamus --> Polydipsia
2 Classification - Central/Neurogenic & Nephrogenic
Others - Hypernatremia, Increased Serum Osmolality, Decreased Urine Osmolality
Investigation
Low Pituitary Hormones
Stimulation Test
Insulin Tolerance Test (ITT)
Principle - Triggers GH & ACTH Release from Pituitary Gland
Interpretation - Failure of Cortisol & GH Increment
Imaging (MRI)
Decreased Secretion of Pituitary Hormones (Anterior and/or Posterior)