Recognition of Pituitary Disease in Long Term Care Residents

Signature Grand, Davie, Florida, USA

Objective. Analyze clinical features, presenting symptoms and laboratory abnormalities in a series of Long Term Care residents identified with Hypopituitarism. Background. Hypopituitarism, a condition with deficiency of one or more anterior pituitary hormones, is recognized in elderly patients. However, the prevalence and impact in Long Term Care (LTC) residents has not been studied. Methods. In this study we report eight cases of LTC residents found to have hypopituitarism (one with known resection of a Macroprolactinoma), and examined the presenting symptoms, diagnostic laboratory abnormalities, potential causes, and treatments. Results. Upon review of the cases 6 out of 8 had pituitary hypofunction presumably secondary to vascular insufficiency. In addition, 2 out of 8 cases were identified to have chronic opiod use, potential cause of pituitary dysfunction. Also, 2 out of 8 cases were also identified to have trauma as a potential cause. All patients were started on replacement therapy for partial or complete pituitary dysfunction. Conclusion. Hypopituitarism, is difficult to diagnose in patient in LTC facilities as the presentation and symptoms are often missed or attributed to other chronic conditions or age. The diagnosis of partial or complete pituitary hypofunction can be made with readily available blood tests, although neuroimaging of the brain and pituitary may also be necessary.