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Hypopituitarism in Children

What is hypopituitarism?

Hypopituitarism, also called an underactive pituitary gland, is a condition that affects the anterior (front) lobe of the pituitary gland, usually resulting in a partial or complete loss of functioning of that lobe. The resulting symptoms depend on which hormones are no longer being produced by the gland. Because the pituitary gland affects the other endocrine organs, effects of hypopituitarism may be gradual, or sudden and dramatic.

What causes hypopituitarism?

Hypopituitarism, in children, is often caused by a benign (noncancerous) pituitary tumor, an injury, or an infection. However, often no exact cause can be determined.

What are the symptoms of hypopituitarism?

Symptoms vary depending on what hormones are insufficiently produced by the pituitary gland. The following are common symptoms associated with reduced production of certain hormones:

Insufficient gonadotropins production
(luteinizing hormone and follicle-stimulating hormone)

In premenopausal women, this leads to absent menstrual cycles, infertility, vaginal dryness, and loss of some female characteristics. In men, this deficiency leads to impotence, shriveling of testes, decreased sperm production, infertility, and loss of some male characteristics.

Insufficient growth hormone production

This usually produces no symptoms in adults. In children, this deficiency can lead to stunted growth and dwarfism.

Insufficient thyroid-stimulating hormone production

This usually leads to an underactive thyroid and may cause confusion, cold intolerance, weight gain, constipation, and dry skin.

Insufficient corticotrophic production

This rare deficiency leads to an underactive adrenal gland, resulting in low blood pressure, a low blood sugar level, fatigue, and a low tolerance for stress.

Insufficient prolactin production

This rare deficiency may cause an inability to produce breast milk after childbirth in some women.

The symptoms of hypopituitarism may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.

How is hypopituitarism diagnosed?

The symptoms of several underactive glands may help your child's doctor diagnose hypopituitarism. In addition to a complete medical history and physical examination, diagnostic procedures for hypopituitarism may include:

  • Computed tomography scan (also called a CT or CAT scan). A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

  • Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

  • Blood tests. Blood tests are used to measure hormone levels.

  • Bone X-rays of the hand. Hand X-rays will determine bone age.

Treatment for hypopituitarism

Specific treatment for hypopituitarism will be determined by your child's doctor based on:

  • Your child's age, overall health, and medical history

  • Extent of the disease

  • Your child's tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

Treatment of hypopituitarism depends on its cause. The goal of treatment is to restore the pituitary gland to normal function, producing normal levels of hormones. Treatment may include specific hormone replacement therapy, surgical tumor removal, and/or radiation therapy.

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