Pituitary Infarction
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Definition
Pituitary infarction is the death of an area of tissue in the pituitary gland, a small gland joined to the hypothalamus (part of the brain). The pituitary produces many of the hormones that control essential body processes.
Alternative Names
Pituitary apoplexy
Causes, incidence, and risk factors
Pituitary infarction is most commonly caused by bleeding due to a noncancerous tumor of the pituitary. When this bleeding occurs in a woman during or right after childbirth, it is called Sheehan syndrome.
Risk factors for pituitary infarction include:
However, in most cases, the cause is not clear.
References
Melmed S, Kleinberg D. Pituitary masses and tumors. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR. Williams Textbook of Endocrinology. 12th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 9.
Review Date: 12/11/2011
Reviewed By: Nancy J. Rennert, MD, Chief of Endocrinology & Diabetes, Norwalk Hospital, Associate Clinical Professor of Medicine, Yale University School of Medicine, New Haven, CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Pituitary apoplexy
Symptoms
Pituitary infarction usually has a short period of symptoms (acute), but it can be life-threatening.
Symptoms usually include:
Less commonly, pituitary dysfunction may appear more slowly. In Sheehan syndrome, for example, the first symptom may be a failure to produce milk caused by a lack of the hormone prolactin.
Over time, problems with other pituitary hormones may develop, causing symptoms of the following conditions:
Increased fat in the abdomen
Lack of energy
Cold intolerance
Constipation
Depressed mood
Dry skin
Fatigue
Hair or skin changes
Hoarseness
Menstrual changes
Mental slowing
Weight gain
When the posterior pituitary is involved (rare), symptoms may include:
- Failure of the uterus to contract as needed to give birth to a baby (in women)
- Failure to produce breast milk (in women)
- Uncontrolled urination
Signs and tests
Signs of acute pituitary infarction may include:
Signs of chronic pituitary insufficiency include:
- Growth hormone deficiency
- Loss of muscle mass
- Problems with fat metabolism (dyslipidemia)
- Hypoadrenalism
- Low blood pressure
- Poor response to stress and infection
- Hypothyroidism
Tests may include:
Blood tests will be done to check levels of:
LH
TSH
Somatomedin C (IGF-1)
References
Melmed S, Kleinberg D. Pituitary masses and tumors. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR. Williams Textbook of Endocrinology. 12th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 9.
Review Date: 12/11/2011
Reviewed By: Nancy J. Rennert, MD, Chief of Endocrinology & Diabetes, Norwalk Hospital, Associate Clinical Professor of Medicine, Yale University School of Medicine, New Haven, CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Pituitary apoplexy
Treatment
Treatment for acute infarction may require surgery to relieve pressure on the pituitary and improve vision symptoms. Severe cases need emergency surgery.
Immediate treatment with adrenal replacement hormones (glucocorticoids) is essential. Other hormones will be replaced, including:
Evidence is also growing for the need to replace growth hormone.
Expectations (prognosis)
Acute pituitary infarction can be life-threatening. The outlook is good for people who have chronic deficiency that is diagnosed and treated.
Complications
Complications of untreated pituitary infarction can include:
If other missing hormones are not replaced, you may develop problems related to hypothyroidism and hypogonadism.
Calling your health care provider
Call your health care provider if you have any symptoms of chronic pituitary insufficiency.
Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of acute pituitary infarction, including:
Be especially concerned if you develop these symptoms and you have already been diagnosed with a pituitary tumor.
References
Melmed S, Kleinberg D. Pituitary masses and tumors. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR. Williams Textbook of Endocrinology. 12th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 9.
Review Date: 12/11/2011
Reviewed By: Nancy J. Rennert, MD, Chief of Endocrinology & Diabetes, Norwalk Hospital, Associate Clinical Professor of Medicine, Yale University School of Medicine, New Haven, CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Pituitary apoplexy
References
Melmed S, Kleinberg D. Pituitary masses and tumors. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR. Williams Textbook of Endocrinology. 12th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 9.
Review Date: 12/11/2011
Reviewed By: Nancy J. Rennert, MD, Chief of Endocrinology & Diabetes, Norwalk Hospital, Associate Clinical Professor of Medicine, Yale University School of Medicine, New Haven, CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 12/11/2011
Reviewed By: Nancy J. Rennert, MD, Chief of Endocrinology & Diabetes, Norwalk Hospital, Associate Clinical Professor of Medicine, Yale University School of Medicine, New Haven, CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.