Hypopituitarism: Recognition, Workup, and Management

SUMMARY Anterior pituitary hormone deficiencies may be due to any lesion in this anatomical region, most commonly benign tumors like pituitary adenomas or craniopharyngiomas, and to surgical or radiation-based treatments of these tumors. Less frequently, cranial traumas, inflammatory or autoimmune processes like lymphocytic hypophysitis, or genetic defects may cause pituitary deficits. The resulting pituitary hormone deficiencies may lead to severe clinical consequences with significant morbidity and often increased mortality despite recent therapeutic improvements. The large observational studies launched for the follow-up of patients treated by GH have provided valuable epidemiological data. In recent years, new etiologies of acquired hypopituitarism have been reported such as hypophysitis following targeted anticancer immune therapies. Hypopituitarism, however, remains predominantly a consequence of benign pituitary tumors and of their treatments.