What is pituitary gland disorder (pituitary gland dysfunction)?

From the Guidelines

Pituitary gland disorder, also known as pituitary gland dysfunction, occurs when the pea-sized pituitary gland at the base of the brain produces either too much or too little of certain hormones, and the most recent and highest quality study 1 suggests that diagnosis and management of pituitary adenomas in childhood and adolescence should be based on a multidisciplinary team approach. Pituitary disorders can result from tumors (most commonly benign adenomas), inflammation, infections, brain injuries, certain medications, or genetic conditions.

• Symptoms vary widely depending on which hormones are affected and may include fatigue, weakness, unexplained weight changes, irregular menstrual periods, reduced fertility, decreased sex drive, increased thirst and urination, growth problems, temperature sensitivity, and mood changes.
• Diagnosis typically involves blood tests to measure hormone levels, imaging studies like MRI to examine the pituitary gland, and sometimes vision tests since pituitary tumors can press on nearby optic nerves.
• Treatment depends on the specific disorder but may include medication to replace deficient hormones (such as levothyroxine for thyroid deficiency, hydrocortisone for adrenal insufficiency, or sex hormones), drugs to control excess hormone production (like cabergoline for prolactinomas), surgery to remove tumors, or radiation therapy, as recommended by the consensus guideline for the diagnosis and management of pituitary adenomas in childhood and adolescence: part 2, specific diseases 1. The key to managing pituitary gland disorders is regular monitoring of hormone levels, as dosages often need adjustment over time to maintain proper hormone balance, and a multidisciplinary team approach to care, as suggested by the study 1.
• The study 1 also highlights the importance of considering the diagnosis of GH excess in children and young people (CYP) whose serum GH levels fail to suppress below 1 μg/l in response to an oral glucose load.
• Additionally, the study 1 provides guidance on the management of hypophysitis, a potential side effect of immune checkpoint inhibitors, which can cause pituitary gland dysfunction.
• Overall, the management of pituitary gland disorders requires a comprehensive and individualized approach, taking into account the specific needs and circumstances of each patient, as emphasized by the study 1.

From the Research

Pituitary Gland Disorder

Pituitary gland disorder, also known as pituitary gland dysfunction, refers to a condition where the pituitary gland does not function properly. The pituitary gland is a small endocrine gland located at the base of the brain that plays a crucial role in regulating various bodily functions, including growth and development, metabolism, and reproductive processes.

Causes and Symptoms

Some common causes of pituitary gland disorder include:

• Tumors, such as prolactinoma, which is the leading cause of pituitary adenoma 2, 3, 4
• Surgical complications, such as oculomotor nerve paresis 3
• Radiation therapy 3
• Certain medications, such as bromocriptine 5, 6

Symptoms of pituitary gland disorder may include:

• Amenorrhea in women 2, 3
• Impotence in men 2
• Galactorrhoea 3
• Headaches
• Vision problems

Treatment Options

Treatment options for pituitary gland disorder depend on the underlying cause and may include:

• Surgery to remove tumors or other abnormalities 2, 3, 6
• Medications, such as bromocriptine, to regulate hormone production 2, 3, 4, 5, 6
• Radiation therapy to shrink tumors 3
• Hormone replacement therapy to replace deficient hormones

Effects of Bromocriptine Treatment

Bromocriptine is a medication commonly used to treat prolactinoma and other pituitary gland disorders. Studies have shown that bromocriptine can effectively decrease serum prolactin levels and reduce tumor size 2, 3, 4, 5. However, long-term use of bromocriptine may lead to increased surgical difficulties and postoperative complications 6. Additionally, bromocriptine may not be effective in treating non-functional tumors 5.

Key Findings

Some key findings from studies on pituitary gland disorder and bromocriptine treatment include:

• Bromocriptine can effectively treat prolactinoma and reduce tumor size 2, 3, 4
• Surgical complications, such as oculomotor nerve paresis, can occur in patients with pituitary gland disorder 3
• Long-term use of bromocriptine may lead to increased surgical difficulties and postoperative complications 6
• Bromocriptine may not be effective in treating non-functional tumors 5