Introduction: Hypopituitarism refers to deficiency of one or more of the pituitary hormones. Hypopituitarism is often partial, thus replacement is individualized. Hormonal replacement improves quality of life in these patients.
Objective: To describe the demographic characteristics and patterns of hormonal replacement in patients with hypopituitarism attending the Endocrinology clinic of a tertiary hospital in Lagos, Nigeria.
Methods: We reviewed charts of patients with hypopituitarism attending the Endocrinology clinic of LUTH over a two year period. Information obtained from the charts included sex, age, aetiology of hypopituitarism and replacement therapy. Results were presented as averages and percentages.
Results: There were 22 patients, 12(55%) males and 10(45%) females. Mean age was 43±11.85 years. 18(81.8%) had macroadenomas; 4(18.2%) microadenomas. Majority (16) of the patients with macroadenoma had undergone adenectomy, compared with 1 among those with microadenoma. Of the 22, 19(86.4%) were on hormonal therapy. The most frequently replaced hormone was Cortisol (14 patients); 12 on oral hydrocortisone, average dose 15 mg daily and 2 on prednisolone tablets, 5 mg daily. Hyperprolactinaemia occurred in 8 patients, 7 were on Tabs Cabergoline, average doses 0.250.5 mg twice weekly; 1 was on Tabs Bromocriptine. Thyroxine replacement was required in 6 patients, average dose 50 mcg daily. 2 patients required Desmopressin replacement. Only 1 male was on replacement with human chorionic gonadotropin. Overall, 11 (50%) required replacement with ≥2 hormones.
Conclusion: Majority of patients reviewed had previous adenectomy, underscoring necessity of endocrine assessment, post-surgery. Hormone replacement is usually life-long. Cortisol was the most frequently replaced. It appears there is a gap in screening for and replacing growth hormone in the clinic.
Keywords: Hypopituitarism, Hormone replacement therapy, Lagos, Nigeria