Ryzhkova E G, Ladygina D O
Central Clinical Hospital of the Management Affair of President Russian Federation.
Central Clinical Hospital of the Management Affair of President Russian Federation; Fomin Women's Health Clinic.
Probl Endokrinol (Mosk). 2022 Jul 5;68(5):32-38. doi: 10.14341/probl13128.
Hypopituitarism is a state of complete or partial deficiency of pituitary hormones, including adrenal insufficiency, hypothyroidism, hypogonadism, growth hormone deficiency, and, rarely, diabetes insipidus.The article describes a clinical case of hypopituitarism due to a pituitary tumor in a postmenopausal woman. Difficulties in diagnosing hypopituitarism were due to a history of primary hypothyroidism. The first identified component of panhypopituitarism in the patient, (central hypothyroidism) had previously been seen as laboratory indications of medication-induced hyperthyroidism.The non-specific nature of the clinical symptoms, as well as a relatively rare combination of endocrine diseases, led to a long examination period and delayed diagnosis of the pituitary tumor.Whether the development of hypopituitarism in a patient with a nonfunctional pituitary tumor is an indication for transsphenoidal pituitary surgery remains a controversial issue. The decision for surgery is made taking into account the characteristics of the course of the disease in a particular patient. In this clinical case, a conservative tactic was chosen with hormone replacement therapy for glucocorticoid and thyroid deficiency.
垂体功能减退是指垂体激素完全或部分缺乏的一种状态，包括肾上腺功能不全、甲状腺功能减退、性腺功能减退、生长激素缺乏，以及罕见的尿崩症。本文描述了一名绝经后女性因垂体肿瘤导致垂体功能减退的临床病例。垂体功能减退的诊断困难是由于患者有原发性甲状腺功能减退病史。该患者全垂体功能减退最先发现的成分（中枢性甲状腺功能减退）此前曾被视为药物性甲状腺功能亢进的实验室指标。临床症状的非特异性，以及内分泌疾病相对罕见的组合，导致了较长的检查期和垂体肿瘤的延迟诊断。对于无功能性垂体肿瘤患者发生垂体功能减退是否是经蝶窦垂体手术的指征仍是一个有争议的问题。手术决策需考虑特定患者疾病过程的特点。在本临床病例中，选择了保守策略，即针对糖皮质激素和甲状腺激素缺乏进行激素替代治疗。
