Which physical findings are characteristic 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

Physical examination findings may be normal in subtle presentations. Patients may present with features attributable to deficiency of target hormones, including hypothyroidism (with a small, soft thyroid gland), adrenal insufficiency, hypogonadism (with small, soft testes in men), and failure to thrive. In women, loss of adrenal and ovarian function results in loss of all androgens; loss of axillary and pubic hair may result.

In the stable patient, with the diverse complaints associated with hypopituitarism, a complete physical examination, including thyroid palpation, genital inspection, and ophthalmic examination, can support the diagnosis of hypopituitarism. During the neurologic and ophthalmic examinations, check specifically for visual acuity, extraocular movements, and bitemporal hemianopsia. Also look for evidence of hormonal hypersecretion due to a large functioning adenoma, such as signs of Cushing disease, acromegaly, or galactorrhea.


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