Endocrine Abstracts

Hypopituitarism as deficiency of one or more anterior pituitary hormones, in adults can be consequence of acquired or genetic causes. Only few published studies investigated population-based aetiology of hypopituitarism. In the last 10 years new risks for hypopituitarism have been recognised (traumatic brain injury-TBI, subarachnoid haemorrhage, cranial irradiation).

Aim: To present our experiences in the aetiology of hypopituitarism based on data collected during last 10 years in Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia. This is a single centre cross-sectional database study.

Patients: A total of 426 patients with hypopituitarism were included, mean age 44.6±0.8 years (range 16–82), male 60.3%.The mean age at diagnosis of hypopituitarism was 37.7±1.2 years. Inclusion criteria were: patients older than 16 years, hypopititarism confirmed by endocrine assessment of pituitary function and MRI of the sellar region. Results are expressed as mean±SE and percentages (%). Adult onset of hypopituitarism (AOGHD) is reported in 73% pts, while childhood onset of hypopituitarism (COGHD) in 27% pts.

Results: The most common causes of hypopituitarism are: nonfunctional pituitary adenoma (160 pts, 37.6%), followed by congenital causes (66 pts, 15.5%). Acromegaly and prolactinomas are present in 30 pts (7.0%) each, followed by craniopharyngiomas (28 pts, 6.6%). TBI was the cause of hypopituitarism in 19 pts, (4.5%). Other aetiologies are reported in less than 4% in each category. Gonadotroph (FSH/LH) and growth hormone (GH) deficiency are the most common pituitary hormone deficiencies (71% and 70.3% respectively) followed by TSH (69%) and ACTH (69%) deficiency.

Conclusion: Our results show that aetiology of hypopituitarism may depend on the period of time study. Our transition clinic with paediatric endocrinologists in the last years influenced high prevalence of congenital hypopituitarism. Similarly our database confirms that patients with brain damage either by traumatic brain injury or cranial irradiation are at high risk for hypopituitarism.

Disclosure: This work was supported by the Serbian Ministry of Science (project number 175033).