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Chapter 13 – Hypopituitarism and Growth Hormone Deficiency

Paul Lee,
Ken K.Y. Ho

  Epidemiology
  Mortality
  Causes
  Pituitary and Hypothalamic Mass Lesions
  Genetic Causes

  Hypopituitarism
  Clinical Features
  Diagnosis and Endocrine Evaluation
  Management

  Growth Hormone Deficiency in Adults
  Causes
  Clinical Features
  Diagnosis
  Who to Treat
  Biochemical Diagnosis
  Growth Hormone Replacement
  Treatment

  Conclusions

Hypopituitarism refers to the deficiency of one or more pituitary hormones. It is seen commonly in endocrine practice and, it is important to note, is associated with increased morbidity and mortality. Clinical manifestations are influenced by the cause, severity, and rate of onset of pituitary hormone deficiency.

Adult patients with hypopituitarism receive substitutive hormone treatment for secondary glucocorticoid, sex steroid, and thyroid hormone deficiency. Until recently, growth hormone (GH) deficiency was not regarded as clinically important, as it was assumed that GH had no physiologic relevance after cessation …