Clinical profile and etiology of hypopituitarism at the University of Santo Tomas hospital

ABSTRACT

OBJECTIVE: To establish data determining the etiology of hypopituitarism in the University of Santo Tomas Hospital (USTH) and to describe the clinical and biochemical profile of these patients.METHODOLOGY: A retrospective descriptive study in a tertiary hospital (USTH) involving patients diagnosed by clinical evaluation and biochemical tests to have hypopituitarism, admitted or seen at the outpatient department from January 2001 to December 2009 and whose charts were available for review. The clinical profile, manifestations and biochemical profile were defined and causes of hypopituitarism identified. Descriptive statistics were applied using percentages and frequency distribution.RESULTS: In the nine-year period (2001-2009), a total of 191 patients were recorded to have hypopituitarism but only 143 (75%) have adequate data available for review. Sixty one (43%) were males and 82 (51%) were females with mean age was 45±6 years. Hypopituitarism was found to be most prevalent in the fourth to fifth decade of life and clinical manifestations were noted with mean duration of 20±4 months. The most predominant documented pituitary hormone deficiency was gonadotrophic hormone (60%) manifesting prominently as decreased libido (82%). The most common target end organ hormone deficiency was secondary adrenal insufficiency (90%) and most prevalent etiology of hypopituitarism was pituitary tumors (40%). Sheehan's syndrome (8%) and tuberculosis (3%) were also noted as a cause of hypopituitarism.CONCLUSION: This study shows that the leading clinical manifestation and documented hormone deficiency of hypopituitarism is hypogonadism. Pituitary adenoma is the most common cause of hypopituitarism along with its treatment. Other causes not commonly seen in other countries but proved to be more prevalent here include Sheehan's syndrome and tuberculosis infection.