What are the key clinical features to consider when diagnosing hypopituitarism in adults?

Key clinical features to consider when diagnosing hypopituitarism in adults include symptoms related to deficiency of one or more pituitary hormones, often presenting insidiously. These features commonly involve fatigue, weakness, weight loss or gain, cold intolerance, and decreased libido due to secondary hypothyroidism, adrenal insufficiency, and hypogonadism respectively ³,⁴.

Patients may also present with symptoms of growth hormone deficiency such as reduced muscle mass, increased fat mass, impaired quality of life, and decreased exercise capacity (Feingold et al., 2000).

Other important clinical signs include hypotension, hyponatraemia, and hypoglycaemia, which reflect cortisol deficiency from secondary adrenal insufficiency ³. Visual field defects or headaches may indicate a mass effect from a pituitary tumour or other structural lesion causing hypopituitarism ¹.

In addition, features such as amenorrhoea or infertility in women and erectile dysfunction in men are key indicators of gonadotropin deficiency ⁴. The presence of polyuria and polydipsia may suggest diabetes insipidus if posterior pituitary function is also affected, although this is less common.

Overall, the diagnosis requires a high index of suspicion based on these clinical features combined with biochemical testing to confirm hormone deficiencies and imaging to identify underlying causes.