Naznin L, Parveen T, Chowdhury M J, Akter S, Chowdhury H
Lt Col Dr Lubna Naznin, Classified Specialist in Pathology, Armed Forces Institute of Pathology (AFIP), Dhaka Cantonment, Dhaka, Bangladesh; E-mail:
Mymensingh Med J. 2020 Oct;29(4):1015-1020.
Hypopituitarism is a rare entity with reported incidence, 4 per 100,000 and about 50% of such patients present with three to five pituitary hormone deficits. A slow onset of symptoms is typical. But, diversified presentations from absence of symptoms to vague clinical features to lethal effects leading to mortality are not uncommon in such disorder. In adults, in such cases symptoms of hypogonadism may be the first noticeable illness for reporting to physicians, but it is often under evaluated or even ignored. Here, we present a case of 40-year-old adult male with panhypopituitarism, who presented with loss of generalized body hair and loss of libido for about last five years but the problem was not evaluated adequately. Later, he developed lethargy, generalized weakness, weight loss and then the underneath cause detected was panhypopituitarism due to pituitary macro adenoma. So, suspicion and hormonal evaluation for hypogonadism would help in early detection and management of progressive hypopituitarism in symptomatic adult patients. Cases of panhypopituitarism need lifelong hormone replacement and follow-up and if pituitary adenoma is present, surgical removal by trans-sphenoidal approach is preferable.
垂体功能减退是一种罕见疾病，报告发病率为每10万人中有4例，约50%的此类患者存在三到五种垂体激素缺乏。症状通常缓慢出现。但是，在这种疾病中，从无症状到模糊的临床特征再到导致死亡的致命影响等多样化表现并不罕见。在成年人中，此类病例性腺功能减退的症状可能是向医生报告的首个明显疾病，但往往评估不足甚至被忽视。在此，我们报告一例40岁成年男性全垂体功能减退病例，该患者在过去约五年中出现全身毛发脱落和性欲减退，但该问题未得到充分评估。后来，他出现嗜睡、全身无力、体重减轻，随后检测到潜在病因是垂体大腺瘤导致的全垂体功能减退。因此，对性腺功能减退进行怀疑和激素评估有助于早期发现和管理有症状成年患者的进行性垂体功能减退。全垂体功能减退病例需要终身激素替代和随访，如果存在垂体腺瘤，经蝶窦手术切除是首选方法。
