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dc.contributor.authorHigham, Claire E
dc.contributor.authorJohannsson, G
dc.contributor.authorShalet, Stephen M
dc.date.accessioned2016-04-14T10:34:01Zen
dc.date.available2016-04-14T10:34:01Zen
dc.date.issued2016-03-31en
dc.identifier.citationHypopituitarism. 2016: Lanceten
dc.identifier.issn1474-547Xen
dc.identifier.pmid27041067en
dc.identifier.doi10.1016/S0140-6736(16)30053-8en
dc.identifier.urihttp://hdl.handle.net/10541/605244en
dc.description.abstractHypopituitarism refers to deficiency of one or more hormones produced by the anterior pituitary or released from the posterior pituitary. Hypopituitarism is associated with excess mortality, a key risk factor being cortisol deficiency due to adrenocorticotropic hormone (ACTH) deficiency. Onset can be acute or insidious, and the most common cause in adulthood is a pituitary adenoma, or treatment with pituitary surgery or radiotherapy. Hypopituitarism is diagnosed based on baseline blood sampling for thyroid stimulating hormone, gonadotropin, and prolactin deficiencies, whereas for ACTH, growth hormone, and antidiuretic hormone deficiency dynamic stimulation tests are usually needed. Repeated pituitary function assessment at regular intervals is needed for diagnosis of the predictable but slowly evolving forms of hypopituitarism. Replacement treatment exists in the form of thyroxine, hydrocortisone, sex steroids, growth hormone, and desmopressin. If onset is acute, cortisol deficiency should be replaced first. Modifications in replacement treatment are needed during the transition from paediatric to adult endocrine care, and during pregnancy.
dc.languageENGen
dc.language.isoenen
dc.rightsArchived with thanks to Lancet (London, England)en
dc.titleHypopituitarism.en
dc.typeArticleen
dc.contributor.departmentDepartment of Endocrinology, Christie Hospital NHS Foundation Trust, Manchester, UKen
dc.identifier.journalLanceten
html.description.abstractHypopituitarism refers to deficiency of one or more hormones produced by the anterior pituitary or released from the posterior pituitary. Hypopituitarism is associated with excess mortality, a key risk factor being cortisol deficiency due to adrenocorticotropic hormone (ACTH) deficiency. Onset can be acute or insidious, and the most common cause in adulthood is a pituitary adenoma, or treatment with pituitary surgery or radiotherapy. Hypopituitarism is diagnosed based on baseline blood sampling for thyroid stimulating hormone, gonadotropin, and prolactin deficiencies, whereas for ACTH, growth hormone, and antidiuretic hormone deficiency dynamic stimulation tests are usually needed. Repeated pituitary function assessment at regular intervals is needed for diagnosis of the predictable but slowly evolving forms of hypopituitarism. Replacement treatment exists in the form of thyroxine, hydrocortisone, sex steroids, growth hormone, and desmopressin. If onset is acute, cortisol deficiency should be replaced first. Modifications in replacement treatment are needed during the transition from paediatric to adult endocrine care, and during pregnancy.


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