Hypopituitarism causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]

Common Causes

Causes can be classified based upon the etiology such as congenital or acquired.

Etiology	Underlying cause/disease	Examples
Congeital	Idiopathic
	Anatomic lesion in sella	Primary empty sella syndrome, Rathke's cyst
	CNS malformations	septo-optic- dysplasia, Kallmann syndrome, and pituitary  stalk interruption syndrome
Acquired	Pituitary tumor	mainly displacing macroadenoma
	Craniopharyngeoma
	Surgery	Transsphenoidal or transcranial surgery in  the hypothalamo-pituitary region
	Radiation
	Systemic cancer treatment
	Traumatic brain injury
	Sheehan's syndrome
	Apolplexy
	Subarachnoid hemorrhage
	Meningitis
	Hypophysitis
	Meningioma	in sellar region
	Lymphoma
	Wegner's granulomatosis
	Hemochromatosis

Less common causes:

Less common causes of hypopituitarism include:

• Peri-natal insults
• Genetic causes, such as Kallman syndrome, Pallister-Hall syndrome and Rieger syndrome. To see a complete list of genetic causes, click here.
• Trauma
• Pituitary hypoplasia or aplasia

Causes by Organ System

Cardiovascular	No underlying causes
Chemical/Poisoning	No underlying causes
Dental	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	No underlying causes
Ear Nose Throat	No underlying causes
Endocrine	No underlying causes
Environmental	No underlying causes
Gastroenterologic	No underlying causes
Genetic	No underlying causes
Hematologic	No underlying causes
Iatrogenic	No underlying causes
Infectious Disease	No underlying causes
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	No underlying causes
Nutritional/Metabolic	No underlying causes
Obstetric/Gynecologic	No underlying causes
Oncologic	No underlying causes
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal/Electrolyte	No underlying causes
Rheumatology/Immunology/Allergy	No underlying causes
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	No underlying causes

Causes in Alphabetical Order

• Anorexia Nervosa
• Bulimia Nervosa
• Changes in body weight
• Congestive Heart Failure
• Emotional disorders
• Empty Sella Syndrome
• Habitual exercise
• Head Trauma
• Hemochromatosis
• Infection

• Fungal
• Malaria
• Meningitis
• Syphillis
• Tuberculosis

• Ischemic nerosis of the pituitary

• Anticoagulant therapy
• Arteriosclerosis
• Arteritis temporalis
• Blood dyscrasias
• Brain Trauma
• Diabetes Mellitus
• Eclampsia
• Increased cranial pressure
• Sheehan's Syndrome
• Sickle Cell Anemia
• Tumor

• Iatrogenic
• Parasellar tumor/pituitary compression

• Craniopharyngioma
• Chromophobe adenoma
• Intracranial cartoid branch aneurysm
• Lymphoma
• Meningioma
• Metasteses
• Optic nerve neuroma

• Pituitary adenomas
• Renal Failure
• Sarcoidosis
• Wegener's Granulomatosis

Hypopituitarism Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Hypopituitarism from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X Ray
CT
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Hypopituitarism causes On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Hypopituitarism causes All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Hypopituitarism causes
CDC on Hypopituitarism causes
Hypopituitarism causes in the news
Blogs on Hypopituitarism causes
Directions to Hospitals Treating Hypopituitarism
Risk calculators and risk factors for Hypopituitarism causes

Etiology based on anatomical location of pathology:

Hypopituitarism can be classified based upon the anatomical location of pathology such as hypothalamus or pituitary gland.

Anatomical location	Cause
Hypothalmic	Mass lesions  Benign (craniopharyngiomas) Malignant tumors (metastatic from lung, breast, etc)
	Radiation :  CNS and nasopharyngeal malignancies
	Infections: Tuberculous meningitis
	Infiltrative lesions: Sarcoidosis Langerhans cell histiocytosis
	Other : Traumatic brain injury Stroke
Pituitary	Mass lesions: Pituitary adenomas Other benign tumors Cysts
	Pituitary radiation
	Pituitary surgery
	Infection/abscess
	Infiltrative lesions: Hypophysitis - Lymphocytic hypophysitis - Granulomatous hypophysitis - Plasmacytic (IgG4-associated) hypophysitis 2. Hemochromatosis
	Infarction: Sheehan syndrome
	Apoplexy
	Empty sella
	Genetic mutations

Genetic Causes

Hypopituitarism is caused by mutation in any one of the following genes.

Isolated hormone abnormalities	Gene	Inheritance	Phenotype
	GH1	AR, AD	Isolated GH deficiency
	GHRHR	AR	Isolated GH deficiency
	TSHB	AR	Isolated TSH deficiency
	TRHR	AR	Isolated TSH deficiency
	TPIT	AR	Isolated ACTH deficiency
	GnRHR	AR	HH
	PC1	AR	ACTH deficiency, hypoglycemia, HH, obesity
	POMC	AR	ACTH deficiency, obesity, red hair
	DAX1	XL	Adrenal hypoplasia congenital and HH
	CRH	AR	CRH deficiency
	KAL1	XL	Kallman syndrome, renal agenesis, synkinesia
	FGFR1	AD, AR	Kallman syndrome, cleft lip and palate, facial dysmorphism
	Leptin	AR	HH, obesity
	Leptin-R	AR	HH, obesity
	GPR54	AR	HH
	Kisspeptin	AR	HH
	FSHB	AR	Primary amenorrhea, defective spermatogenesis
	LHB	AR	Delayed puberty
	PROK2	AD	Kallman syndrome, severe sleep disorder, obesity
	PROKR2	AD, AR	Kallman syndrome
	AVP-NPII	AR, AD	Diabetes insipidus
Combined pituitary hormone deficiency	POU1F1	AR, AD	GH, TSH and prolactin deficiencies
	PROP1	AR	GH, TSH, LH, FSH, prolactin, and evolving ACTH deficiencies
Specific syndromes	HESX1	AR, AD	Septo-optic dysplasia
	LHX3	AR	GH, TSH, LH, FSH, prolactin deficiencies, limited neck rotation
	LHX4	AD	GH, TSH, ACTH deficiencies with cerebellar abnormalities
	SOX3	XL	Hypopituitarism and mental retardation
	GLI2	AD	Holoprosencephaly and multiple midline defects
	SOX2	AD	Anophthalmia, hypopituitarism, oesophageal atresia
	GLI3	AD	Pallister-Hall syndrome
	PITX2	AD	Rieger syndrome