Features due to hormone deficiencies

Hypopituitarism may present with loss of anterior or posterior pituitary hormones. The loss of anterior pituitary hormones is usually partial and occurs in the order:

• Growth hormone deficiency:
  • pituitary dwarfism in children - diminished skeletal growth, retarded sexual development, normal intelligence, hypoglycaemic episodes
  • wrinkling of skin, tendency to hypoglycaemia in adults
    
    
• Gonadotrophin deficiency:
  • delay in puberty in children
  • amenorrhoea, impotency, loss of libido in adults
    
    
• TSH deficiency:
  • isolated TSH deficiency is very rare
  • secondary hypothyroidism - sensitivity to cold, dry skin, physical and mental sluggishness, coarseness of hair
    
    
• ACTH deficiency:
  • decreased skin pigmentation
  • poor apetite, nausea, vomiting, fatigue, muscle weakness, loss of axillary and pubic hair in females
    
    
• Prolactin deficiency:
  • failure of lactation in post-partum patients

Loss of posterior pituitary hormones:

• ADH deficiency:
  • polyuria, thirst