Pituitary Disorders
The Pituitary gland is located at the base of the brain behind the eyes also known as the “Master Gland” of the body. It controls multiple hormones and can be affected from birth or later in life. Congenital or acquired cases can cause the pituitary gland to be deficient in one or several hormones. The pituitary gland is responsible for producing ACTH (adrenocorticotropic hormone), TSH (thyroid stimulating hormone), GH (growth hormone), ADH (anti-diuretic hormone), LH (luteinizing hormone) and FSH (follicle stimulating hormone). Panhypopituitarism is a deficiency in one or more of these hormones. Congenital conditions such as septo-optic dysplasia or other anatomic abnormalities can be the culprit in infants. In older children, radiation to the brain or tumors can cause panhypopituitarism.
Signs and Symptoms
Infants:
- Underdeveloped genitalia
- Low Blood Sugars
- Persistent Nystagmus (wandering eyes)
- Diabetes Insipidus (excessive urination with dehydration)
Older Children
- Poor Growth
- Increased Thirst and Urination
- Fatigue
- Delayed Puberty
- Visual Changes
Evaluation
Usually, the evaluation begins with blood tests to look at the various pituitary hormones and possibly an ACTH stimulation test. If there is a concern for Diabetes Insipidus (lack of ADH), urine tests or a water deprivation test may be done. MRI of the brain may also be done to evaluate the anatomy of the pituitary gland.
Treatment
Treatment involves replacing any hormones that are deficient with hormone replacement therapy. If there is an anatomical cause such as Septo-Optic Dysplasia, the child may also need to be followed by Ophthalmology and Neurology. If there is concern for a tumor, an oncologist may also be consulted.
