What is the role of glucocorticoids in the treatment of hypopituitarism (panhypopituitarism)?

Updated: Jun 09, 2020
  • Author: Bernard Corenblum, MD, FRCPC; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Patients with hypopituitarism are maintained on hormone replacement therapies for life, unless the causative disorder is reversed by treatment or by natural history. These medically replaced patients are generally asymptomatic but require increased doses of glucocorticoids following any form of stress, emotional or physical. The most common stressor is infection. Not matching glucocorticoid dose to stress causes acute decompensation. These patients present with nausea and vomiting and may be hypotensive and ill-appearing. A patient's initial presentation of undiagnosed hypopituitarism may be with this life-threatening decompensated state under stress.


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