The pituitary gl& is called the master endocrine gl& of the toàn thân because it controls the function of other endocrine organs. The anterior pituitary produces the hormones thyrotropin (thyroid-stimulating hormone ), corticotropin (adrenocorticotropic hooc môn ), luteinizing hormone (LH), follicle-stimulating hormone (FSH), growth hormone (GH), & prolactin (PRL). The anterior pituitary is controlled by specific hypothalamic-releasing hormones. The posterior pituitary produces vasopressin (antidiuretic hormone ) và oxytocin.quý khách vẫn xem: Pituitary gland là gì

Panhypopituitarism is a condition of inadequate or absent production of the anterior pituitary hormones. It is frequently the result of other problems that affect the pituitary glvà và either reduce or destroy its function or interfere with hypothalamic secretion of the varying pituitary-releasing hormones. Panhypopituitarism can be the end result of various clinical scenargame ios. The signs & symptoms are diverse. Manifestations that suggest congenital anterior hypopituitarism include micropenis, midline defects, optic atrophy, hypoglycemia, và poor growth.


Pathophysiology of panhypopituitarism.

Diagnosis and management

The diagnostic evaluation of a child with hypopituitarism is divided inkhổng lồ 2 portions: recognition of the hormonal deficiencies and determination of the cause. Genetic testing is available at various commercial và academic laboratories for mutations associated with hypopituitarism.

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In TSH deficiency, the dose of L-thyroxine replacement is age dependent. In cases of gonadotropin deficiency, sex steroid replacement should begin at puberty, while in GH deficiency, GH replacement doses should be administered in doses of 0.18-0.3 mg/kg/wk subcutaneously, divided in 6-7 doses. Higher doses of up to 0.7 mg/kg/wk may be beneficial in puberty.



The effects of hypopituitarism in children depend on the affected hormones. GH deficiency can result in hypoglycemia và short stature.

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Gonadotropin deficiency leads to lớn prenatal micropenis & delayed or interrupted puberty in older children. Corticotropin deficiency interferes with normal carbohydrate, protein, & lipid metabolism & may result in weight loss, hypoglycemia, fatigue, hypotension, và death. Thyrotropin deficiency leads lớn hypothyroidism.

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US frequency

Hypopituitarism is caused by various conditions & is associated with various hormonal deficiencies. Thus, data are limited regarding frequency rates of the various etiologies và components. An Italian study reported GH deficiency prevalence to lớn be approximately 9 cases per 1000 individuals in a pediatric population. Data from the Northwest Regional Screening program estimate the frequency of congenital TSH deficiency at 1 case per 29,000 live births.

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A study by Kao et al indicated that adults with childhood-onset multiple pituitary hooc môn deficiencies (COMPHD) have sầu a significantly worse quality of life than do healthy adults. Compared with healthy controls, adults with COMPHD were shorter and more overweight, had less education, were less likely to be married, & had a higher unemployment rate, lower incomes, và fewer children. They also scored lower on the Female Sexual Function Index and Male Sexual Quotient.

Previous Clinical Presentation References

Setian N, Aquiar CH, Galvao JA. Rathke"s cleft cyst as a cause of growth hooc môn deficiency và micropenis. Child"s Nervous System. 1999. Vol 5: 271-3.

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