endocrine and metabolic disorders
Selective Pituitary Hormone Deficiencies
Introduction
Selective deficiencies of pituitary hormones may represent an early stage in the development of more Generalized Hypopituitarism . Patients must be observed for signs of other pituitary hormone deficiencies, and sellar imaging should be done at intervals to check for signs of a pituitary tumor. (Pituitary structure and function and relationships between the hypothalamus and the pituitary gland are discussed in Overview of the Endocrine System .) is responsible for many cases of Growth Hormone Deficiency in Children . Although one autosomal dominant form of complete GH deficiency is associated with a deletion of the GH structural gene, such gene defects probably account for a minority of cases. Treatment of GH deficiency in adults is discussed elsewhere (see levels, and infertility. A eunuchoid habitus (tall, thin, and with long arms and legs) is generally present. However, patients with Etiology have elevated levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), whereas those with gonadotropin deficiency, either secondary (pituitary) or tertiary (hypothalamic), have low-normal, low, or unmeasurable levels of LH and FSH. Although most cases of hypogonadotropic hypogonadism involve deficiencies of both LH and FSH, in rare cases the secretion of only one is impaired. Isolated gonadotropin deficiency must also be distinguished from hypogonadotropic Secondary hypogonadism , Secondary Adrenal Insufficiency None Hypothyroidism None Isolated prolactin deficiencyhas been noted rarely in women who fail to lactate after delivery. Basal prolactin levels are low and do not increase in response to provocative stimuli, such as thyroid-releasing hormone. Administration of prolactin is not indicated. 