Major Depressive Disorder as the First Presentation of Panhypopituitarism: A Case Report

Pan-hypopituitarism is a rare but life threatening disorder that occurs due to reduction of anterior pituitary hormones. In this condition, major depressive disorders are presented by depressed mood and markedly diminished interest in many activities during a day. Some disorders are associated with psychiatric symptoms at presentation, therefore, the diagnosis of mood disorder due to a medical condition should also be considered. This study presents a middle aged man admitted with symptoms of major depressive disorder involving suicidal ideation whose condition did not improve despite treatment with different antidepressant agents. He had past history of brain tumor surgery, chemotherapy, and radiotherapy. Due to the possibility of pituitary axis deficits since the time that radiotherapy was initiated, the patient was evaluated for these axes and the decrease in adrenal, thyroid, gonad and growth hormone axis function was confirmed by lab tests.In patients with persistent and severe depression, underlying medical causes such as endocrine disorders especially hypo-pituitarism should also be considered.