Hypopituitarism in older adults. The report of five cases with different presentations.

Patients with hypopituitarism may present with myriad signs and symptoms which result from reduced secretion of one or more pituitary hormones. Severe hyponatremia and hypoglycemia are rare, but potentially life threatening presenting clinical features of hypopituitarism. As these abnormalities are completely restored with replacement therapy and patients are often undiagnosed until admission, a high clinical suspicion is necessary to diagnose a patient with hypopituitarism. We present five cases, each exhibiting rare symptoms of hypopituitarism--severe hyponatremia, hypoglycemia and osteoporosis--as the only presenting feature; these cases illustrate that hypopituitarism must be considered in the differential diagnosis of these abnormalities, especially in older patients.