Hypopituitarism

뇌하수체 기능저하증(Hypopituitarism)은 각 anterior pituitary hormone의 결핍증상으로 나타난다.

●Damage to the anterior pituitary can occur suddenly or slowly, can be mild or severe, and can affect the secretion of one, several, or all of its hormones. As a result, the clinical presentation of anterior pituitary hormone deficiencies varies, depending upon the rapidity with which a disease affects anterior pituitary cells, the severity of the hormonal deficiency, and the number of hormone deficiencies. (See 'General principles' above.)

●The presentation of corticotropin (ACTH) deficiency is almost exclusively that of the resulting cortisol deficiency. There are two important clinical distinctions between cortisol deficiency due to ACTH deficiency (secondary adrenal deficiency) and cortisol deficiency due to adrenal disease (primary adrenal insufficiency) with a secondary increase in ACTH release (see "Clinical manifestations of adrenal insufficiency in adults", section on 'Secondary or tertiary adrenal insufficiency'):

•ACTH deficiency does not cause salt wasting, volume contraction, and hyperkalemia because it does not result in clinically important deficiency of aldosterone.

•ACTH deficiency does not result in hyperpigmentation.

●The clinical manifestations of thyroid-stimulating hormone (TSH) deficiency (secondary/central hypothyroidism) are similar to those of primary hypothyroidism for similar degrees of deficiency. (See "Central hypothyroidism", section on 'Clinical manifestations'.)

●Deficient secretion of the gonadotropins follicle-stimulating hormone (FSH) and luteinizing hormone (LH) results in hypogonadotropic (secondary) hypogonadism in both women and men. (See 'Gonadotropins' above.)

●Growth hormone deficiency in children typically presents as short stature. Likely clinical manifestations of growth hormone deficiency in adults are changes in body composition (increased fat mass with a decrease in lean body mass) and decreased bone mineral density (BMD) in men. Also possible, but not yet confirmed, are decreased BMD in women, dyslipidemia, cardiovascular disease, impaired psychological function, and an increase in mortality. (See "Growth hormone deficiency in adults", section on 'Clinical manifestations'.)

●The only known clinical manifestation of prolactin deficiency is the inability to lactate after delivery.