Hypopituitarism laboratory findings: Difference between revisions
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*A subnormal/reduced concentration of pituitary hormones is diagnostic of hypopituitarism.<ref name="pmid27736313">{{cite journal |vauthors=Fleseriu M, Hashim IA, Karavitaki N, Melmed S, Murad MH, Salvatori R, Samuels MH |title=Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline |journal=J. Clin. Endocrinol. Metab. |volume=101 |issue=11 |pages=3888–3921 |year=2016 |pmid=27736313 |doi=10.1210/jc.2016-2118 |url=}}</ref> | *A subnormal/reduced concentration of pituitary hormones is diagnostic of hypopituitarism.<ref name="pmid27736313">{{cite journal |vauthors=Fleseriu M, Hashim IA, Karavitaki N, Melmed S, Murad MH, Salvatori R, Samuels MH |title=Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline |journal=J. Clin. Endocrinol. Metab. |volume=101 |issue=11 |pages=3888–3921 |year=2016 |pmid=27736313 |doi=10.1210/jc.2016-2118 |url=}}</ref> | ||
*Any history of a lesion causing hypopituitarism or a symptom suggestive of hypopituitarism is an indication for testing for hypopituitarism. | *Any history of a lesion causing hypopituitarism or a symptom suggestive of hypopituitarism is an indication for testing for hypopituitarism. | ||
=== Corticotopin: === | |||
==== Basal ACTH secretion: ==== | |||
Normal range of serum cortisol is 5 to 25 mcg/dL (138 to 690 nmol/L). Serum cortisol levels are measured at 8 to 9 am and results are interpreted as follows: | |||
{| class="wikitable" | |||
!Serum cortisol | |||
!Basal ACTH | |||
|- | |||
|Low: ≤3 mcg/dL (83 nmol/L) | |||
|Cortisol deficiency | |||
|- | |||
|High: ≥18 mcg/dL (497 nmol/L) | |||
|No cortisol deficiency even in times of stress | |||
|- | |||
|Intermediate: >3 mcg/dL (83 nmol/L) | |||
but | |||
<18 mcg/dL (497 nmol/L) | |||
|Needs evaluation for ACTH reserve | |||
|} | |||
*Laboratory findings consistent with the diagnosis of hypopituitarism include: | *Laboratory findings consistent with the diagnosis of hypopituitarism include: | ||
{| class="wikitable" | {| class="wikitable" | ||
Revision as of 16:18, 5 September 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: {IQ}
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Overview
- An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].
- Laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
- [Test] is usually normal among patients with [disease name].
- Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].
OR
- There are no diagnostic laboratory findings associated with [disease name].
Laboratory Findings
- A subnormal/reduced concentration of pituitary hormones is diagnostic of hypopituitarism.[1]
- Any history of a lesion causing hypopituitarism or a symptom suggestive of hypopituitarism is an indication for testing for hypopituitarism.
Corticotopin:
Basal ACTH secretion:
Normal range of serum cortisol is 5 to 25 mcg/dL (138 to 690 nmol/L). Serum cortisol levels are measured at 8 to 9 am and results are interpreted as follows:
| Serum cortisol | Basal ACTH |
|---|---|
| Low: ≤3 mcg/dL (83 nmol/L) | Cortisol deficiency |
| High: ≥18 mcg/dL (497 nmol/L) | No cortisol deficiency even in times of stress |
| Intermediate: >3 mcg/dL (83 nmol/L)
but <18 mcg/dL (497 nmol/L) |
Needs evaluation for ACTH reserve |
- Laboratory findings consistent with the diagnosis of hypopituitarism include:
| Hormonal deficiency | Lab finding | ||
|---|---|---|---|
| ACTH | |||
| TSH | |||
| Gonadotropins | |||
| Growth hormone | |||
| Prolactin | |||
| ADH | |||
| Oxytocin |
References
- ↑ Fleseriu M, Hashim IA, Karavitaki N, Melmed S, Murad MH, Salvatori R, Samuels MH (2016). "Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline". J. Clin. Endocrinol. Metab. 101 (11): 3888–3921. doi:10.1210/jc.2016-2118. PMID 27736313.