Pituitary disorders

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Pituitary disorders

Overview

Classification

Hypopituitarism
TSH Deficiency
Cortisol Deficiency
FSH and LH Deficiency
ADH Deficiency
GH deficiency
Pituitary apoplexy
Sheehan syndrome
Hyperpituitarism
TSH Excess
Prolactin Excess
GH Excess
Cortisol Excess
ADH Excess

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]

Synonyms and keywords:

Overview

Pituitary disorders can be classified as hypopituitarism or hyperpituitarism depending upon the particular hormone levels. Hypopituitarism can present as the deficiency of one hormone produced by the pituitary, multiple hormones or all the hormones produced by the pituitary simultaneously. A deficiency of all the hormones is called panhypopituitarism. Hypopituitarism may present as single hormone deficiency, such as hypothyroidism due to thyroid stimulating hormone TSH deficiency, Addison's disease due to cortisol deficiency, hypogonadism because of follicular stimulating hormone (FSH) and luteinizing hormone (LH) deficiency, diabetes insipidus (DI) due to anti diuretic hormone (ADH) deficiency, growth hormone (GH) deficiency, pituitary apoplexy or Sheehan syndrome. Hyperpituitarism may present as hyperthyroidism i.e. TSH excess, prolactinoma leading to prolactin excess, acromegaly i.e. GH excess, Cushing's disease i.e. cortisol excess or SIADH i.e. ADH excess. Symptoms and signs of these spectrum of diseases depend on the specific hormone deficiencies and the sequence of their lack. Diagnosis of these diseases is usually based on net hormone assays, stimulation tests, suppression tests, and imaging. Treatment is usually medical but in some instances surgery is required to remove the source of hormonal excess.

Classification



 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Pituitary Disorders
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Hypopituitarism
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Hyperpituitarism
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Partial-hypopituitarism
 
Panhypopituitarism
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
GH deficiency
 
 
TSH Deficiency
 
 
 
 
FSH and LH Deficiency
 
 
ADH Deficiency
 
 
 
TSH Excess
 
 
 
 
 
GH Excess
 
 
 
 
ADH Excess
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Pituitary apoplexy
 
 
Cortisol Deficiency
 
 
Sheehan syndrome
 
 
 
 
 
 
 
 
Prolactin Excess
 
 
 
 
Cortisol Excess