Primary hypopituitarism |
- Neoplasms leading to pituitary destruction |
Intrasellar tumors (adenomas, craniopharyngiomas) |
Parasellar tumors (meningiomas, optic nerve gliomas) |
Metastatic tumors (breast, lung, melanoma, renal cell carcinoma) |
- Ischemic necrosis of the pituitary |
Postpartum (Sheehan's syndrome) |
Diabetes mellitus |
Other systemic disorders (sickle cell disease and traits, temporal arteritis, eclampsia, atherosclerotic disease, hemorrhagic fever with renal syndrome) |
- Pituitary apoplexy (nearly always secondary to a pituitary tumor) |
- Cavernous sinus thrombosis |
- Aneurysms of intracranial internal carotid artery |
- Infectious disease (tuberculous meningitis, fungal disease, malaria, HIV) |
- Infiltrative disease (hemochromatosis, secondary amyloidosis) |
- Immunological or inflammatory (lymphocytic or granulomatous hypophysitis, sarcoidosis) |
- Primary empty sella syndrome |
- Iatrogenic |
Nasopharyngeal, pituitary, or brain irradiation |
Surgical destruction |
- Genetic (PIT-1, GH, β-LH, GHRH-R mutations or deletions) |
- "Idiopathic" (GH, ACTH, TSH, others): frequently monohormonal |
Secondary hypopituitarism: pituitary stalk, hypothalamus or other central nervous system diseases |
Tumors (craniopharyngioma, germ cell tumor, metastasis, lymphoma, leukemia) |
Infiltrative (hemochromatosis, lipid storage disease) |
Traumatic brain injury |
Hormone-induced (glucocorticoids, gonadal steroids) |
Iatrogenic (surgical, irradiation) |
Infectious (HIV, tuberculosis) |
Nutritional (starvation, obesity) |
Anorexia nervosa |
Severe systemic illness (interleukin mediated) |
Psychoneuroendocrine (psychosocial dwarfism, stress-associated amenorrhea) |
Genetic (vasopressin-neurophysin gene, KAL1 gene) |