Anterior Pituitary Failure

Anterior pituitary failure results from a variety of different etiologies; sellar/suprasellar masses and treatment(s), infiltrative and infectious diseases, genetic mutations, and traumatic brain injury are the most frequent causes of hypopituitarism. If not recognized and appropriately treated, hypopituitarism leads to increased mortality. The clinical presentation of hypopituitarism is determined by underlying etiology, age of onset, and the number and type of pituitary hormones affected. A diagnosis of pituitary failure relies on measurement(s) of anterior pituitary hormones and related target hormones. Dynamic testing is required when a diagnosis cannot be made by baseline hormonal evaluation. Depending on the clinical picture and desired outcome, treatment of hypopituitarism typically involves the replacement of target hormones (cortisol, thyroid hormone, gonadal hormones) or pituitary hormones (growth hormone; occasionally follicle-stimulating hormone and luteinizing hormone), and, in rare cases, hypothalamic hormones.