Hypopituitarism physical examination

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Hypopituitarism Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2], Iqra Qamar M.D.[3]

Overview

Clinical presentation in hypopituitarism depends upon the onset, the severity of hormonal deficiency and the number of deficient hormones. Patients with hypopituitarism are ill appearing and usually look tired. Physical examination of patients with hypopituitarism is usually remarkable for the respective hormonal deficiency and present with features of that specific hormone such as hypothyroidism presents as delayed relaxation of tendon reflexes, bradycardia, coarse skin, puffy facies, and loss of eyebrows. ACTH deficiency can present with postural hypotension, tachycardia, and weight loss. Gonadotropin deficiency may present with breast atrophy, soft testes, and regression of sexual characteristics. Growth hormone deficiency can present with short stature, decreased sweating with impaired thermogenesis, and reduced muscle mass.

Physical Examination

Clinical presentation in hypopituitarism depends upon factors as followings:

Hormonal deficiency Finding
ACTH Acute
Chronic
TSH
  • Slow movement and slow speech
Gonadotropins Male
Female
Growth hormone Children
Adults

Appearance of the patient

Vital Signs

Skin

Lungs

Heart

Abdomen

Neuromuscular

Genitourinary

References

  1. Fleseriu, Maria; Hashim, Ibrahim A.; Karavitaki, Niki; Melmed, Shlomo; Murad, M. Hassan; Salvatori, Roberto; Samuels, Mary H. (2016). "Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline". The Journal of Clinical Endocrinology & Metabolism. 101 (11): 3888–3921. doi:10.1210/jc.2016-2118. ISSN 0021-972X.
  2. Prabhakar VK, Shalet SM (2006). "Aetiology, diagnosis, and management of hypopituitarism in adult life". Postgrad Med J. 82 (966): 259–66. doi:10.1136/pgmj.2005.039768. PMC 2585697. PMID 16597813.
  3. Ascoli, Paola; Cavagnini, Francesco (2006). "Hypopituitarism". Pituitary. 9 (4): 335–342. doi:10.1007/s11102-006-0416-5. ISSN 1386-341X.
  4. Arlt W, Allolio B (2003). "Adrenal insufficiency". Lancet. 361 (9372): 1881–93. doi:10.1016/S0140-6736(03)13492-7. PMID 12788587.

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