hypopituitarism?

I really hope that you can help me. I'm a student and I'm doing a case study about a patient but I'm not completely sure about the diagnosis.
Symptoms:
-18 yr old male
-slow onset of puberty
-short stature
-slightly obese
-frequent headaches
-basal plasma gonadotropins low for low plasma testosterone
-X-ray showed enlarged pituitary fossa
-prolactin levels high
-follicle stimulating hormones low
-synacthen test showed very slight increase in cortisol
-triple function test showed increase in glucose, decrease in thyroid releasing hormone.

I think that it's hypopituitarism but I'm not sure. Could it also be addison's disease?

Thank you ever so much for your help!

[HFHS M.D.-SW]

Dear Julie,

Your question may be better answered by an endocrinologist.
From my understanding Hypopituitarism results from diminished secretion of one or more pituitary hormones. The cause can be congenital or acquired.  The clinical manifestations depend on the hormones involved.

Best Wishes,


HFHS M.D-SW

[NRO-Sx]

In order to rule out Addison's disease (unlikely), one needs to demonstrate hypocortisolemia.  The most specific test for diagnosing Addison's is the ACTH stimulation test.  Hypogonadotropic hypogonadism should be considered in the differential because of late onset of puberty, low serum testosterone, low FSH and hyperprolactinemia.  Further testing for SHBG, LH, IGF-1 and ACTH should prove useful.