Endocrine Abstracts

Introduction: Hypopituitarism is a clinical syndrome that develops as a result of inadequate production and release of one or more pituitary hormones. The prevalence is 45/100,000 and the incidence is 4/100,000 cases/year. Here, we aimed to present a patient with complete pituitary hormone deficiency.

Case: A 75-year-old woman had been followed up with hypertension for 20 years and osteoporosis for 16 years. She underwent surgery 7 years ago for a femur fracture due to a fall. She was admitted to our clinic because of 11 kg weight loss and anemia for the last 6 months. In her anamnesis, we were informed that she had a long history of fatigue, loss of appetite, slowed movements and depressive appearance. She had 6 birth stories and breastfed all her children. She had her last period at the age of 45. We were informed that the patient had a history of 2 head traumas at the age of 15 and 65 years. Basal pituitary hormones and pituitary MRI were requested from the patient with poor general condition. Whole body CT, endoscopy and colonoscopy were requested because of weight loss and anemia. The hormone results were consistent with those of panhypopituitarism (Table 1). The pituitary MRI revealed that pituitary height decreased by 2.5 mm and this result is compatible with partial empty sella. Age-related changes were detected on the whole body CT. Endoscopy and colonoscopy were normal. The DEXA T score was reported as L1-L4: −3, L2-L4: −3.1 and femoral neck: −2.6. Corticosteroids, levothyroxine replacement and bisphosphonate-calcium were initiated. The patient, whose general condition was better, was followed up.

Discussion: Since most of the signs and symptoms seen in pituitary hormone deficiencies in adult patients are non-specific, we suggest that the most important step to avoid a dela, in diagnosis is to carefull, investigate the cause.