Bei einer Hypophyseninsuffizienz besteht ein partieller oder kompletter Ausfall der
Sekretion eines Hormons oder mehrerer Hormone der Hypophyse – mit oft schwerwiegenden
Folgen. Ziel des Beitrags ist es, ätiologisch und pathophysiologisch fundiert die
Diagnostik und Therapie zu vermitteln und dafür zu sensibilisieren, bei Funktionsdefiziten
von Endorganen mit unspezifischen Symptomen auch an eine Hypophyseninsuffizienz zu
denken.
Abstract
Pituitary insufficiency is a partial or complete failure of secretion of one or more
hormones from the pituitary gland. The pituitary gland is located in the hypophysial
fossa of the sella turcica of the os sphenoidale and produces ACTH, LH, FSH, GH, TSH,
and prolactin. Pituitary insufficiency can be caused by acute damage, such as secondary
to traumatic brain injury. It can also be a result of chronic alterations, such as
increasing tumor expansion.
Pituitary insufficiency often presents with nonspecific symptoms (e.g. fatigue, listlessness,
decreased performance, sleep disturbances, weight change) that leads to a challenging
and sometimes delayed diagnosis. The symptoms correspond to the failure of the corresponding
endorgans. Occasionally, symptoms such as a loss of libido, secondary amenorrhea or
nausea in stressful situations are diagnostically indicative.
Further clarification includes a clinical examination with endocrinological testing
of the pituitary function. Alteration of pituitary hormone secretion can also occur
physiologically as in pregnancy, depression or obesity. Substitution therapy of the
failed corticotropic, thyrotropic and gonadotropic axis is corresponding to the therapy
of a primary endorgan insufficiency. Adequate diagnosis and treatment of pituitary
insufficiency is important, as this may prevent life-threatening crises such as an
adrenal crisis.
Schlüsselwörter
Hypophyseninsuffizienz - Neuroendokrinologie - Funktionsdiagnostik - Hormontherapie
Keywords
hypopituitarism - neuroendocrinology - functional diagnostics - hormone therapy
