Hypopituitarism (an underactive pituitary gland) is rare in children. When a child has hypopituitarism, the pituitary gland has lost its ability to make one, some or all pituitary hormones. The condition is often permanent, but very treatable.
The pituitary gland — in the middle of the head and brain — is the body’s master gland. The table below describes what each hormone made by the pituitary gland does, what happens when each hormone is missing and medication that can replace each hormone.
In children, hypopituitarism is usually caused by something congenital (the child is born with the problem) or by a pituitary tumor. The tumor interferes with the gland. Sometimes, the cause cannot be determined.
Sometimes, the cause was present before the child was born. Often, we see that the pituitary gland is under-developed. A genetic error may be the reason the gland doesn’t work well.
Children with septo-optic dysplasia have varying degrees of hypopituitarism. Their vision is usually impaired because the optic nerves are under-developed. The eyes can move irregularly or “wander.” This disorder can affect the pituitary gland and other structures in the brain. Often, these children have diabetes insipidus and not enough growth hormone.
There are other forms of congenital hypopituitarism. Sometimes, the pituitary gland doesn’t make enough growth hormone. Sometimes, the thyroid gland is underactive, or the adrenal gland doesn’t work well. In Kallman syndrome, not enough of the hormones that stimulate the testes or ovaries are made, puberty is late or doesn’t happen, and the sense of smell is affected.
A tumor can cause hypopituitarism. The tumor may grow in the pituitary gland or outside the gland, compressing the normal tissue. Parents worry that the tumor may be cancer, but that’s unlikely.
Rarely, one of these conditions leads to this hormone problem:
Some hormone deficiencies cause complications over time. Our experienced doctors help you understand any long-term or serious effects of the missing hormones. For example:
Signs and symptoms vary, depending on which hormones are lacking and the child’s age.
Common symptoms in newborns:
Common symptoms in older infants and children:
The symptoms you see may be due to other conditions and medical problems. Always talk to your child’s doctor if you have a concern.
Our approach to diagnosing hypopituitarism is very thorough. We take one step at a time and minimize invasive procedures.
We can use other tests as needed. For example:
We know that the weeks of waiting for the full picture can be difficult. Our compassionate team and family-friendly environment support your family while we progress toward the answers and plan the right treatment. As soon as possible, you’ll receive a call from a doctor or nurse about what we’ve found and the next steps to take.
We treat the cause of the condition and replace the hormones the body isn’t making.
Hormone replacement therapy mimics the body’s natural production. The medicines can be continued as long as needed, during childhood and adulthood. These medications are tolerated very well when the right amounts of hormones are replaced. The following are examples of hormone replacement therapy:
Some tumors respond to medicine that is swallowed. Other tumors need to be removed with surgery. Usually, the hormone deficiencies remain after a tumor is removed. Hormone therapy works for this.
To be effective, hormone replacement must be supported with ongoing care. Throughout childhood, we need to adjust the hormone doses to accommodate the growing child’s needs and changes in symptoms. We evaluate the child’s growth and development frequently and develop a working relationship with parent and child.
Our resources help bring the right specialists into your child’s care to make sure the child gets the best treatment possible. Our endocrinologists and neurosurgeons co-manage patients in our hospital. Tools such as our electronic health record help nurses and doctors throughout the team work closely together.
We care for children with all forms of hypopituitarism. We treat each hormone deficiency to maintain the child’s health and normal development. With the right care plan, children with hypopituitarism usually enjoy a normal life. We help the child to develop normally, interact with peers and feel well.
Learn more about pituitary disorders by visiting these physician-recommended websites: