Hypopituitarism (Simmonds’ disease)

Published on 02/04/2015 by admin

Filed under Internal Medicine

Last modified 02/04/2015

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143 Hypopituitarism (Simmonds’ disease)

Instruction

Look at this patient.

Salient features

History

• In a male, frequency of shaving, impotence

• In a female, postpartum haemorrhage, amenorrhoea

• History of radiation (e.g. proton-beam radiation): causes hypopituitarism primarily because of its effects on hypothalamic function whereas high-dose radiation can directly affect the pituitary.

Examination

• Patient is pale; the skin is soft

• Paucity of axillary and pubic hair

• Atrophy of breast (in females)

• Examine the BP for postural hypotension

• Check visual fields: bitemporal hemianopia (p. 188) may be present

• Examine the fundus for optic atrophy

• Tell the examiner that you would like to examine the external genitalia for hypogonadism (small testes).

Diagnosis

This patient has pale soft skin and absence of axillary hair with atrophied breasts (lesion) caused by hypopituitarism (functional status) secondary to postpartum necrosis (aetiology).

Questions

Mention a few causes of hypopituitarism

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