What are the referral criteria for a patient suspected of having a pituitary adenoma causing hypopituitarism?

Referral criteria for a patient suspected of having a pituitary adenoma causing hypopituitarism:

• Arrange urgent referral to endocrinology for specialist assessment if secondary hypothyroidism is suspected, as this may indicate pituitary dysfunction including pituitary adenoma.
• Refer patients with clinical features of hypopituitarism such as symptoms of adrenocorticotropic hormone deficiency (weakness, fatigue, weight loss, hypotension, hyponatraemia, hypoglycaemia), growth hormone deficiency (decreased energy, low mood, cognitive symptoms), sex hormone deficiency (loss of body hair, reduced sex drive, menstrual irregularities, erectile dysfunction), thyroid-stimulating hormone deficiency (fatigue, cold intolerance, weight gain), or vasopressin deficiency (polyuria, polydipsia) for specialist evaluation.
• Consider referral if there are atypical or difficult to interpret thyroid function tests, which may suggest a TSH-secreting pituitary adenoma.
• Urgent referral is warranted if there is suspicion of a pituitary mass causing compressive symptoms such as visual changes or neurological deficits.

These criteria ensure timely specialist assessment for diagnosis and management of pituitary adenomas causing hypopituitarism, including appropriate hormonal replacement and further imaging or surgical intervention if needed.

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