Causes of Hypopituitarism

Cause

Examples

Causes primarily affecting the pituitary gland (primary hypopituitarism)

Pituitary tumors

Adenoma

Craniopharyngioma

Autoimmune dysfunction

Lymphocytic hypophysitis

Iatrogenic

Medications (eg, hypophysitis due to immune checkpoint inhibitors such as CTLA-4 and PD-1/PDL-1 inhibitors)

Irradiation

Surgical extirpation

Idiopathic isolated or multiple pituitary hormone deficiencies

Infarction or ischemic necrosis

Hemorrhagic infarction (pituitary apoplexy)

Shock, especially postpartum (Sheehan syndrome), or in diabetes mellitus or sickle cell disease

Vascular thrombosis or aneurysm, especially of the internal carotid artery

Infiltrative disorders

Hemochromatosis

Langerhans cell histiocytosis

Inflammatory processes

Meningitis (tubercular, other bacterial, fungal, malarial)

Pituitary abscess

Sarcoidosis

Causes primarily affecting the hypothalamus (secondary hypopituitarism)

Hypothalamic tumors

Craniopharyngioma

Ependymoma

Meningioma

Metastatic tumor

Pinealoma

Iatrogenic

Surgical transection of the pituitary stalk

Inflammatory processes

Sarcoidosis

Neurohormone deficiencies of the hypothalamus

Isolated

Multiple

Trauma

Basal skull fracture

CTLA-4 = cytotoxic T-lymphocyte-associated protein 4; PD-1 = programmed cell death protein 1 ; PDL-1 = programmed cell death ligand 1.