History A 34-year-old man presented with generalized fatigue , increased thirst , greater urinary frequency , volume , decreased nocturnal erections , and reduced sexual desire . These symptoms were prevalent in the patient for the last eight months before he visited the endocrinology clinic. In addition, in the past six months, he was suffering from dry skin, constipation, cold tolerance and a weight loss of 18 Kg . However, the patient did not report any vision problems, headaches, use of illegal substances, or any incidence of recent head trauma.
The man was already put on cortisone acetate and levothyroxine therapy by his primary care physician before he reported at the clinic. Clinical assessment Physical examination: Normal vital signs and a delayed tendon reflex in the upper and lower limbs were noted. Initial serum and urine laboratory examination: Hypopituitarism,…
