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hypopituitarism?
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD), bipolar disorder, dementia, electroconvulsive therapy (ECT), learning disabilities, memory, obsessive compulsive disorder (OCD), panic, personality disorders, phobias, post-traumatic stress disorder (PTSD), schizophrenia, stress, transitions, and work problems.

hypopituitarism?

by Julie, Nov 15, 1999 12:00AM
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!





by HFHS M.D.-SW, Nov 17, 1999 12:00AM
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
Member Comments

by NRO-Sx, Nov 15, 1999 12:00AM
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.

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