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Diagnosis and Treatment of Hypopituitarism in Adults

Yıl 2019, , 225 - 229, 01.08.2019
https://doi.org/10.32708/uutfd.510272

Öz

Hypopituitarism is characterized by total or
partial loss of anterior and posterior pituitary gland function due to
hypophyseal or hypothalamic diseases. It causes adrenal insufficiency,
hypothyroidism, hypogonadism, growth hormone deficiency and rarely diabetes
insipidus. The most common causes of primary hypopituitarism are pituitary
adenomas and complications from surgery or radiation therapy for the treatment
of pituitary adenoma. Clinical findings are frequently associated with severity
of hormonal deficits. However hypopituitarism generally remains clinically
silent until a stressful event such as a concurrent infection or trauma. Because
of the increased morbidity and mortality, early diagnosis and prompt treatment
is important. Patients should be monitored for long-term and avoided under- or
overtreatment.

Kaynakça

  • 1. Gounden V, Jialal I. Hypopituitarism (panhypopituitarism). StatPearl Publishing; 2018-.
  • 2. Hannoush ZC, Weiss RE. Hypopituitarism: Emergencies. In: De Groot LJ, Chrousos G, Dungan K, editors. Endotext. South Dartmouth (MA): MD Text.com, Inc.; 2000-2018.
  • 3. Chung TT, Koch CA, Monson JP. Hypopituitarism. In: De Groot LJ, Chrousos G, Dungan K, editors. Endotext. South Dartmouth (MA): MD Text.com, Inc.; 2000-2018.
  • 4. Fleseriu M, Hashim IA, Karavitaki N, et al. Hormonal replacement in hypopituitarism in adults: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016 Oct 13: jc20162118.
  • 5. Melmed S. The pituitary. 3rd ed. London: Academic press; 2011.
  • 6. Higham CE, Johannson G, Shalet SM. Hyypopituitarism. Lancet 2016;388: 2403-2415.
  • 7. Pekic S, Popovic V. Expanding the cause of hypopituitarism. Eur J Endocrinol. 2017;176(6): 269-282.
  • 8. Swords FM. Uncertainties in endocrine substitution therapy for central hypocortisolism. Handb Clin Neurol. 2014;124:387–396.
  • 9. Arlt W, Allolio B. Adrenal insufficiency. Lancet. 2003;361:1881– 1893.
  • 10. Alexopoulou O, Beguin C, De Nayer P, Maiter D. Clinical and hormonal characteristics of central hypothyroidism at diagnosis and during follow up in adult patients. Eur J Endocrinol 2004;150: 1-8.
  • 11. Snyder PJ, Cooper DS, Martin KA. Clinical manifestations of hypopituitarism. https://0210eqnr1-y-https-www-uptodate-com.proxy.uludag.deep-knowledge.net/contents/clinical-manifestations-of-hypopituitarism.
  • 12. Brambilla DJ, O’Donnell AB, Matsumoto AM, et al. Intraindividual variation in levels of serum testosterone and other reproductive and adrenal hormones in men. Clin Endocrinol (Oxf). 2007;67: 853–862.
  • 13. Karavitaki N, Wass J. Disorders of the anterior pituitary gland. In: Warrell DD, Cox TM, Firth JD, eds. Oxford Textbook of Medicine. 5th ed. Chap 13.2. Oxford, UK: Oxford University Press; 2010:1799–1818.
  • 14. Ushiroyama T, Sakuma K, Ikeda A, Ueki M. Adequate reduction degree of pituitary gonadotropin levels in the clinical management of short-term hormone replacement therapy of women with menopausal symptoms. J Med. 2004;35: 281–294.
  • 15. Molitch ME, Clemmons DR, Malozowski S, Merriam GR, Vance ML. Endocrine Society. Evaluation and treatment of adult growth hormone deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011 Jun;96(6): 1587–609.
  • 16. Carroll PV, Christ ER, Bengtsson BA, et al. Growth hormone deficiency in adulthood and the effects of growth hormone replacement: a review. Growth Hormone Research Society Scientific Committee. J Clin Endocrinol Metab. 1998;83(2): 382–395.
  • 17. Hamrahian AH, Yuen KC, Gordon MB, et al. Revised GH and cortisol cut-points for the glucagon stimulation test in the evaluation of GH and hypothalamic-pituitary-adrenal axes in adults: results from a prospective randomized multicenter study. Pituitary. 2016;19: 332–341.
  • 18. Vance ML. Hypopituitarism. N Eng J Med. 1994;330: 1651-1662.
  • 19. Snyder PJ, Cooper DS, Martin KA. Diagnostic testing for hypopituitarism. https://0210eqnst-y-https-www-uptodate-com.proxy.uludag.deep-knowledge.net/contents/diagnostic-testing-for-hypopituitarism).
  • 20. Esteban NV, Loughlin T, Yergey AL, et al. Daily cortisol production rate in man determined by stable isotope dilution/mass spectrometry. J Clin Endocrinol Metab. 1991;72: 39–45.
  • 21. Maclennan AH, Broadbent JL, Lester S, et al. Oral oestrogen and combined oestrogen/progestogen therapy versus placebo for hot flushes. Cochrane Database Syst Rev. 2004;Cd002978.
  • 22. Hackett G. An update on the role of testosterone replacement therapy in management of hypogonadism. Ther Adv Urol2016;8(2): 147-160.
  • 23. Leung KM, Alrabeeah K, Carrier S. Update on testosterone replacement therapy in hypogonadal men. Curr Urol Rep. 2015;16: 57.
  • 24. Feneley MR, Carruthers M. Is testosteron treatment good for the prostate? Study of safety during long-term treatment. J Sex Med. 2012;9(8): 2138-2149. 25. Corona G, Rastrelli G, Forti G, et al. Update in testosterone therapy for men. J Sex Med 2011;8(3):639-654.
  • 26. Zacharin MR, Pua J, Kanumakala S. Bone mineral density out-comes following long-term treatment with subcutaneous testosterone pellet implants in male hypogonadism. Clin Endocrinol. 2003;58(6): 691-695.
  • 27. Løkkegaard E, Jovanovic Z, Heitmann BL, et al.The association between early menopause and risk of ischaemic heart disease: influence of hormone therapy. Maturitas. 2006;53: 226–233.
  • 28. Stuenkel CA, Davis SR, Gompel A, et al. Treatment of symptoms of the menopause: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2015;100: 3975–4011.
  • 29. Melmed S. Idiopathic adult growth hormone deficiency. J Clin Endocrinol Metab. 2013;98: 2187–2197.
  • 30. Baldeweg SE, Ball S, Brooke A, et al. Society of endocrinology clinical guidance: inpatient management of cranial diabetes insipidus. Endocr Connect. 2018;7:G8–G11.
  • 31. Linas SL, Berl T, Robertson GL, et al. Role of vasopressin in the impaired water excretion of glucocorticoid deficiency. Kidney Int. 1980;18: 58–67.

Erişkinde Hipopitüitarizmin Tanı ve Tedavisi

Yıl 2019, , 225 - 229, 01.08.2019
https://doi.org/10.32708/uutfd.510272

Öz

Hipopitüitarizm hipofizer ya da hipotalamik
hastalıklar nedeniyle ön ve arka hipofiz bez fonksiyonlarında total ya da kısmi
kayıp olması ile karakterizedir. Adrenal yetmezlik, hipotiroidizm,
hipogonadizm, büyüme hormon eksikliği ve nadiren diyabetes insipidusa neden
olur. En sık nedeni hipofiz adenomları ve tedavide uygulanan cerrahi ve
radyasyon tedavisinin neden olduğu komplikasyonlardır. Klinik bulgular sıklıkla
hormonal eksikliğin şiddeti ile ilişkilidir. Bununla birlikte hipopituitarizm
genellikle eşlik eden enfeksiyon ve travma gibi strese yol açabilecek durumlara
kadar klinik olarak sessiz seyreder. Artmış morbidite ve mortaliteye yol açması
nedeniyle erken tanı ve uygun tedavi önemlidir. Hastalar uzun dönem izlenmeli
ve eksik ya da aşırı hormon replasman uygulamalarından kaçınılmalıdır. 

Kaynakça

  • 1. Gounden V, Jialal I. Hypopituitarism (panhypopituitarism). StatPearl Publishing; 2018-.
  • 2. Hannoush ZC, Weiss RE. Hypopituitarism: Emergencies. In: De Groot LJ, Chrousos G, Dungan K, editors. Endotext. South Dartmouth (MA): MD Text.com, Inc.; 2000-2018.
  • 3. Chung TT, Koch CA, Monson JP. Hypopituitarism. In: De Groot LJ, Chrousos G, Dungan K, editors. Endotext. South Dartmouth (MA): MD Text.com, Inc.; 2000-2018.
  • 4. Fleseriu M, Hashim IA, Karavitaki N, et al. Hormonal replacement in hypopituitarism in adults: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016 Oct 13: jc20162118.
  • 5. Melmed S. The pituitary. 3rd ed. London: Academic press; 2011.
  • 6. Higham CE, Johannson G, Shalet SM. Hyypopituitarism. Lancet 2016;388: 2403-2415.
  • 7. Pekic S, Popovic V. Expanding the cause of hypopituitarism. Eur J Endocrinol. 2017;176(6): 269-282.
  • 8. Swords FM. Uncertainties in endocrine substitution therapy for central hypocortisolism. Handb Clin Neurol. 2014;124:387–396.
  • 9. Arlt W, Allolio B. Adrenal insufficiency. Lancet. 2003;361:1881– 1893.
  • 10. Alexopoulou O, Beguin C, De Nayer P, Maiter D. Clinical and hormonal characteristics of central hypothyroidism at diagnosis and during follow up in adult patients. Eur J Endocrinol 2004;150: 1-8.
  • 11. Snyder PJ, Cooper DS, Martin KA. Clinical manifestations of hypopituitarism. https://0210eqnr1-y-https-www-uptodate-com.proxy.uludag.deep-knowledge.net/contents/clinical-manifestations-of-hypopituitarism.
  • 12. Brambilla DJ, O’Donnell AB, Matsumoto AM, et al. Intraindividual variation in levels of serum testosterone and other reproductive and adrenal hormones in men. Clin Endocrinol (Oxf). 2007;67: 853–862.
  • 13. Karavitaki N, Wass J. Disorders of the anterior pituitary gland. In: Warrell DD, Cox TM, Firth JD, eds. Oxford Textbook of Medicine. 5th ed. Chap 13.2. Oxford, UK: Oxford University Press; 2010:1799–1818.
  • 14. Ushiroyama T, Sakuma K, Ikeda A, Ueki M. Adequate reduction degree of pituitary gonadotropin levels in the clinical management of short-term hormone replacement therapy of women with menopausal symptoms. J Med. 2004;35: 281–294.
  • 15. Molitch ME, Clemmons DR, Malozowski S, Merriam GR, Vance ML. Endocrine Society. Evaluation and treatment of adult growth hormone deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011 Jun;96(6): 1587–609.
  • 16. Carroll PV, Christ ER, Bengtsson BA, et al. Growth hormone deficiency in adulthood and the effects of growth hormone replacement: a review. Growth Hormone Research Society Scientific Committee. J Clin Endocrinol Metab. 1998;83(2): 382–395.
  • 17. Hamrahian AH, Yuen KC, Gordon MB, et al. Revised GH and cortisol cut-points for the glucagon stimulation test in the evaluation of GH and hypothalamic-pituitary-adrenal axes in adults: results from a prospective randomized multicenter study. Pituitary. 2016;19: 332–341.
  • 18. Vance ML. Hypopituitarism. N Eng J Med. 1994;330: 1651-1662.
  • 19. Snyder PJ, Cooper DS, Martin KA. Diagnostic testing for hypopituitarism. https://0210eqnst-y-https-www-uptodate-com.proxy.uludag.deep-knowledge.net/contents/diagnostic-testing-for-hypopituitarism).
  • 20. Esteban NV, Loughlin T, Yergey AL, et al. Daily cortisol production rate in man determined by stable isotope dilution/mass spectrometry. J Clin Endocrinol Metab. 1991;72: 39–45.
  • 21. Maclennan AH, Broadbent JL, Lester S, et al. Oral oestrogen and combined oestrogen/progestogen therapy versus placebo for hot flushes. Cochrane Database Syst Rev. 2004;Cd002978.
  • 22. Hackett G. An update on the role of testosterone replacement therapy in management of hypogonadism. Ther Adv Urol2016;8(2): 147-160.
  • 23. Leung KM, Alrabeeah K, Carrier S. Update on testosterone replacement therapy in hypogonadal men. Curr Urol Rep. 2015;16: 57.
  • 24. Feneley MR, Carruthers M. Is testosteron treatment good for the prostate? Study of safety during long-term treatment. J Sex Med. 2012;9(8): 2138-2149. 25. Corona G, Rastrelli G, Forti G, et al. Update in testosterone therapy for men. J Sex Med 2011;8(3):639-654.
  • 26. Zacharin MR, Pua J, Kanumakala S. Bone mineral density out-comes following long-term treatment with subcutaneous testosterone pellet implants in male hypogonadism. Clin Endocrinol. 2003;58(6): 691-695.
  • 27. Løkkegaard E, Jovanovic Z, Heitmann BL, et al.The association between early menopause and risk of ischaemic heart disease: influence of hormone therapy. Maturitas. 2006;53: 226–233.
  • 28. Stuenkel CA, Davis SR, Gompel A, et al. Treatment of symptoms of the menopause: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2015;100: 3975–4011.
  • 29. Melmed S. Idiopathic adult growth hormone deficiency. J Clin Endocrinol Metab. 2013;98: 2187–2197.
  • 30. Baldeweg SE, Ball S, Brooke A, et al. Society of endocrinology clinical guidance: inpatient management of cranial diabetes insipidus. Endocr Connect. 2018;7:G8–G11.
  • 31. Linas SL, Berl T, Robertson GL, et al. Role of vasopressin in the impaired water excretion of glucocorticoid deficiency. Kidney Int. 1980;18: 58–67.
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Endokrinoloji
Bölüm Derleme Makaleler
Yazarlar

Pınar Şişman 0000-0002-6561-6207

Özen Öz Gül

Yayımlanma Tarihi 1 Ağustos 2019
Kabul Tarihi 16 Mayıs 2019
Yayımlandığı Sayı Yıl 2019

Kaynak Göster

APA Şişman, P., & Öz Gül, Ö. (2019). Erişkinde Hipopitüitarizmin Tanı ve Tedavisi. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 45(2), 225-229. https://doi.org/10.32708/uutfd.510272
AMA Şişman P, Öz Gül Ö. Erişkinde Hipopitüitarizmin Tanı ve Tedavisi. Uludağ Tıp Derg. Ağustos 2019;45(2):225-229. doi:10.32708/uutfd.510272
Chicago Şişman, Pınar, ve Özen Öz Gül. “Erişkinde Hipopitüitarizmin Tanı Ve Tedavisi”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 45, sy. 2 (Ağustos 2019): 225-29. https://doi.org/10.32708/uutfd.510272.
EndNote Şişman P, Öz Gül Ö (01 Ağustos 2019) Erişkinde Hipopitüitarizmin Tanı ve Tedavisi. Uludağ Üniversitesi Tıp Fakültesi Dergisi 45 2 225–229.
IEEE P. Şişman ve Ö. Öz Gül, “Erişkinde Hipopitüitarizmin Tanı ve Tedavisi”, Uludağ Tıp Derg, c. 45, sy. 2, ss. 225–229, 2019, doi: 10.32708/uutfd.510272.
ISNAD Şişman, Pınar - Öz Gül, Özen. “Erişkinde Hipopitüitarizmin Tanı Ve Tedavisi”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 45/2 (Ağustos 2019), 225-229. https://doi.org/10.32708/uutfd.510272.
JAMA Şişman P, Öz Gül Ö. Erişkinde Hipopitüitarizmin Tanı ve Tedavisi. Uludağ Tıp Derg. 2019;45:225–229.
MLA Şişman, Pınar ve Özen Öz Gül. “Erişkinde Hipopitüitarizmin Tanı Ve Tedavisi”. Uludağ Üniversitesi Tıp Fakültesi Dergisi, c. 45, sy. 2, 2019, ss. 225-9, doi:10.32708/uutfd.510272.
Vancouver Şişman P, Öz Gül Ö. Erişkinde Hipopitüitarizmin Tanı ve Tedavisi. Uludağ Tıp Derg. 2019;45(2):225-9.

ISSN: 1300-414X, e-ISSN: 2645-9027

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