panhypopituitarism /panhī′pōpito̅o̅″itəriz′əm/ [Gk, pan + hypo, under, pituita, phlegm] , generalized insufficiency of pituitary hormones, resulting from damage to or deficiency of the gland. Prepubertal panhypopituitarism, a rare disorder usually associated with a suprasellar cyst or craniopharyngioma, is characterized by dwarfism with normal body proportions, subnormal sexual development, and insufficient thyroid and adrenal function. Diabetes insipidus is frequently present, bitemporal hemianopia or complete blindness may occur, and skin is often yellow and wrinkled, but mentality is usually unimpaired. X-ray films show delayed fusion of the epiphyses, suprasellar calcification, and, frequently, destruction of the sella turcica. The condition is treated with cortisone, thyroid and sex hormone replacement, and human growth hormone. Postpubertal panhypopituitarism may be caused by postpartum pituitary necrosis (Sheehan’s syndrome) resulting from thrombosis of pituitary circulation during or after delivery or other trauma to the pituitary. Characteristic signs of the disorder are failure to lactate, amenorrhea (in females), weakness, cold intolerance, lethargy, and loss of libido and of axillary and pubic hair. There may be bradycardia or hypotension, and progression of the disorder leads to premature wrinkling of the skin and atrophy of the thyroid and adrenal glands. Treatment consists of the administration of the hormones of the target organs. Panhypopituitarism may also be caused by pituitary apoplexy, hemorrhage, or head trauma. Also called hypophyseal cachexia, pituitary cachexia, Simmonds’ disease.
