Endocrine Abstracts

Pituitary adenomas/ tumours remain the commonest cause of growth hormone deficiency (GHD; indeed recent studies from the UK and Belgium have reported higher than previously estimated prevalence of clinically significant pituitary adenomas). However, the aetiological spectrum of pituitary dysfunction has changed in recent years with endocrinologists increasingly reviewing patients with pituitary dysfunction secondary to radiation injury, traumatic brain injury and subarachnoid haemorrhage.

With the improving survival rate for patients with tumours of the head, neck and central nervous system pituitary dysfunction secondary to cranial irradiation more frequent (the GH/ IGF1 axis is the most sensitive to radiation injury). This is also the case for survivors of childhood cancers in particular those treated with cranial and total body irradiation. A number of factors are key predictors of risk of hypopituitarism; the dose and site of irradiation, age of patient and duration since radiation.

Two other conditions, which have been associated with GHD and dysfunction of other pituitary axis are traumatic brain injury and subarachnoid haemorrhage.

Impaired quality of life and functional capacity is described commonly following both cranial irradiation and traumatic brain injury and the associated GHD and other axis deficiency may have a role to play in these abnormalities. GHD has been postulated as being an explanation for some of these symptoms, however to date there is a paucity of data regarding the impact of hormone replacement on quality of life and functional capacity in these patients.

This symposium will highlight the changing aetiology of pituitary dysfunction and the challenges in diagnosis and treatment of these patients.