Endocrine Abstracts

Background: Hypopituitarism is considered to be a risk factor for cardiovascular disease and early death in humans. However, some studies showed that most patients with isolated GH deficiency or combined pituitary hormonal deficiency due to gene mutations (PROP 1, GH receptors gene, GH-1 gene) can survive to advanced age.

Aim: To collect clinical data on patients with congenital hypopituitarism older than 50 years identified in the Department of Neuroendocrinology, Belgrade, Serbia between 2005 and 2012.

Patients: Our database contains in total 56 patients with congenital hypopituitarism. Eight of them are older than 50 years (five females and three males, range 53–66 years). Their adult phenotype is typical for childhood onset hypopituitarism, with dwarfism, dry wrinkled skin and lack of sexual development. Their final heights are from 127 to 168 cm and BMI from 16.4 to 31.2 kg/m². According to the number of anterior pituitary hormone deficiencies out of eight elderly patients, five have GHD3 while three patients have GHD2. These patients were not treated with GH, started hormone replacement treatment late in adulthood and were not compliant with the replacement therapy. However, their bone mineral density is not reduced. Glucose metabolism is normal in all and only one patient presented with abnormal lipid profile. They did not have any serious diseases during the life-time. Unfortunately one female and one male patient died due to gastrointestinal bleeding of unknown cause. In most presented patients MRI showed pituitary stulk disconnection and small pituitary.

Conclusion: Our data show that patients with congenital hypopituitarism in advanced age can still have a healthy life style with the abscence of cancer, metabolic and cardiovascular diseases.