How is an acute cortisol insufficiency state prevented in hypopituitarism (panhypopituitarism)?

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

A diagnosis of hypopituitarism may be missed if apparently normal pituitary hormone levels are interpreted with respective subnormal target organ hormone levels. Adrenal insufficiency should be treated upon suspicion and definitive diagnosis made posttherapy. Blood could be drawn to measure serum cortisol and ACTH prior to initiating glucocorticoid therapy. Adrenal replacement should precede thyroxine (T4) replacement to avoid a possible acute cortisol insufficiency state.


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