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垂体功能减退症的进展更新:病因、诊断及当前治疗

An Update on Advances in Hypopituitarism: Etiology, Diagnosis, and Current Management.

作者信息

Iglesias Pedro

机构信息

Department of Endocrinology and Nutrition, Hospital Universitario Puerta de Hierro Majadahonda, Calle Joaquín Rodrigo, 1, 28222 Majadahonda, Madrid, Spain.

Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana, 28222 Majadahonda, Madrid, Spain.

出版信息

J Clin Med. 2024 Oct 16;13(20):6161. doi: 10.3390/jcm13206161.

Abstract

This article provides an updated review of hypopituitarism (HP), an endocrine disorder characterized by a deficiency of one or more pituitary hormones. The various etiologies are reviewed, including pituitary neuroendocrine tumors (PitNETs), hypothalamic lesions, genetic mutations, and acquired factors such as head trauma, medications, neoplasms, and infiltrative diseases. It is noted that PitNETs are responsible for approximately half of the cases in adults, whereas in children the causes are predominantly congenital. Diagnosis is based on clinical evaluation and hormonal testing, with identification of the specific hormonal deficiencies essential for effective treatment. Laboratory tests present challenges and limitations that must be understood and addressed. Hormone replacement therapy is the mainstay of treatment, significantly improving patients' quality of life. It is important to know the possible interactions between hormone replacement therapies in HP. Recent advances in understanding the pathophysiology of HP and the importance of a multidisciplinary approach to the management of associated complications are discussed. This article emphasizes the need for comprehensive evaluation and continuous follow-up to optimize outcomes in patients with HP and highlights the importance of ongoing research to improve diagnostic and treatment strategies.

摘要

本文对垂体功能减退症(HP)进行了更新综述,这是一种以内分泌紊乱为特征的疾病,表现为一种或多种垂体激素缺乏。文章回顾了多种病因,包括垂体神经内分泌肿瘤(PitNETs)、下丘脑病变、基因突变以及后天因素,如头部外伤、药物、肿瘤和浸润性疾病。需要注意的是,PitNETs约占成人病例的一半,而在儿童中,病因主要是先天性的。诊断基于临床评估和激素检测,确定特定的激素缺乏对有效治疗至关重要。实验室检查存在必须了解和解决的挑战与局限性。激素替代疗法是主要治疗方法,可显著改善患者生活质量。了解HP中激素替代疗法之间可能的相互作用很重要。文中讨论了在理解HP病理生理学方面的最新进展以及多学科方法对处理相关并发症的重要性。本文强调对HP患者进行全面评估和持续随访以优化治疗结果的必要性,并突出了持续研究对改进诊断和治疗策略的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a35/11508259/09931359117a/jcm-13-06161-g001.jpg

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