Hypopituitarism in Children

What is hypopituitarism in children?

Hypopituitarism means that the pituitary gland is not making enough hormones. The pituitary gland is a pea-sized gland located at the base of the brain. It’s the master endocrine gland in the body. The pituitary gland normally releases as many as 8 different hormones. These hormones control growth, metabolism, blood pressure, and other body processes. The effects of hypopituitarism may happen slowly over time, or they can appear more quickly.

What causes hypopituitarism in a child?

In children, hypopituitarism is often caused by one of the following:

• Pituitary tumor that isn’t cancer (benign)
• Brain injury, including from radiation therapy
• Autoimmune problem
• An infection
• A genetic condition

The condition may be present at birth (congenital). Often no exact cause can be found.

Which children are at risk for hypopituitarism?

A child is at risk for hypopituitarism if they have any of these:

• Pituitary tumor
• Head injury
• Infection of the covering of the brain and spinal cord (meningitis)

What are the symptoms of hypopituitarism in a child?

Symptoms vary and depend on which hormones are most affected. Common symptoms include:

• A small penis in a newborn boy
• Low blood sugar (hypoglycemia)
• Slow growth
• Short height
• Late or no sexual maturity
• Yellow tint to skin and eyes (jaundice) at birth
• Low appetite
• Weight loss or weight gain
• Sensitivity to cold
• Puffy face
• Severe headache and double vision if the injury to the pituitary is sudden

The signs of hypopituitarism can be like other health conditions. Make sure your child sees their healthcare provider for a diagnosis.

How is hypopituitarism diagnosed in a child?

The healthcare provider will ask about your child’s symptoms and health history. They may also ask about your family’s health history. Your child will also have a physical exam:

• Blood tests.  These are done to check hormone levels.
• X-ray. This test uses a small amount of radiation to make images of tissues inside the body. An X-ray may be done of the left hand and wrist. This can estimate your child's bone age. With hypopituitarism, bone age is often younger than calendar age.
• CT scan. This test uses a series of X-rays and a computer to make detailed images of the body. A CT scan can show bones, muscles, fat, and organs. CT scans are more detailed than regular X-rays.
• MRI. This test uses large magnets and a computer to make detailed images of tissues in the body without the use of X-rays.

How is hypopituitarism treated in a child?

Your child's healthcare provider will consider your child's age, overall health, and other factors when advising treatment. Your child may need to see a pediatric endocrinologist. This is a provider with extra training in treating children with hormone problems.

Treatment depends on its cause. The goal of treatment is to restore the hormones your child is lacking. Hormone replacement therapy may be done. If a tumor is the cause, surgery or radiation therapy may be done to remove or shrink the tumor.

What are possible complications of hypopituitarism in a child?

Possible complications of the condition depend on which hormones are not being made. The pituitary gland is the master endocrine gland of the body. It helps control growth, metabolism, blood pressure, and other vital body processes. The most common problems for children include slow growth and late sexual development.

How can I help my child live with hypopituitarism?

Hypopituitarism is a lifelong condition. But with ongoing treatment, a child can have a full, healthy life. Work with your child's healthcare providers to create an ongoing plan to manage your child’s condition. Follow the treatment plan and medicine schedule as directed by your providers. Keep all follow-up appointments and contact your child's medical team right away if you have questions or new symptoms develop.

When should I call my child's healthcare provider?

Call your child's healthcare provider if new symptoms develop or you are concerned about your child's growth or development.

Key points about hypopituitarism in children

• Hypopituitarism means that the pituitary gland is not making enough hormones. The pituitary gland is the master endocrine gland in the body. It normally releases several different hormones. These hormones control growth, metabolism, blood pressure, and other body processes.
• In children, hypopituitarism is often caused by a pituitary tumor or brain injury. Often no exact cause can be found.
• Common symptoms include slow growth, short height, and late or no sexual maturity.
• Hormone replacement therapy may be done. If a tumor is the cause, surgery or radiation therapy may be done to remove or shrink the tumor.
• Hypopituitarism is a lifelong condition. But with ongoing treatment a child can have a full, healthy life.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
• Ask if your child’s condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.