Endocrine Abstracts

Introduction: Pituitary insufficiency results from the failure of the anterior pituitary gland to secrete hormones, and has many causes. Nonspecific clinical manifestations can delay the diagnosis. Our study aims to detail the clinical, biological, radiological, and etiological aspects of pituitary insufficiency, evaluate treatment and identify factors associated with complications.

Material and methods: This retrospective study includes patients over 18 years of age with biologically confirmed pituitary insufficiency. We describe in detail demographic, clinical, paraclinical, etiological and therapeutic aspects. An in-depth analysis identifies factors contributing to diagnostic delays and complications.

Results: The mean age of patients was 59 years, with a sex ratio (M/F) of 0.79. Pituitary insufficiency was often discovered by signs of hyposecretion (27.9%), complications such as pituitary apoplexy, hyponatremia and acute adrenal insufficiency (34.88%), or during a systematic work-up for pituitary adenoma (37.2%). Clinically, 74.4% showed signs of corticotropic insufficiency, 55.8% of gonadotropic insufficiency, and 27.9% of hypothyroidism. Hormonal investigations revealed corticotropic (88.4%), thyrotropic (62.8%), gonadotropic (55.8%), somatotropic (13.95%) and lactotropic (13.95%) deficiencies. Imaging showed abnormalities in 83.72% of cases, including macroadenoma (51.6%), craniopharyngioma (7.1%), inflammatory pathology (11.9%), Sheehan syndrome (7%), empty sella turcica (4.8%), and genetic pathology (9.5%). Iatrogenic, infectious and microadenoma causes have a prevalence of 2.4% each.

Conclusion: Our study highlights an increased prevalence of pituitary insufficiency in women. Vague clinical signs often lead to late diagnosis. A thorough diagnostic approach and individualized therapeutic management are crucial to optimize clinical outcomes in patients with pituitary insufficiency.