Hypothermic coma: Some patients feel confused in winter, and when exposed to cold, coma can be induced or the coma that has already occurred can be prolonged. This type of crisis often occurs in winter, with a slow onset and gradual entry into a coma with a very low body temperature, which does not rise when measured with an ordinary thermometer, but only when the anal temperature is measured with a thermometer used in the laboratory, which can be as low as nearly 30°C. Hypopituitarism is the result of damage to the pituitary gland that causes inadequate secretion of multiple or single adenohypopituitary hormones. It occurs in the postpartum period and is commonly referred to as Sheehan’s syndrome. If the patient also has pituitary hormone deficiency, it is called panhypopituitarism. Causes of hypothermic coma: Hypopituitarism is caused by damage to the pituitary gland resulting in inadequate secretion of multiple or single pituitary hormones. It occurs in the postpartum period and is often referred to as Sheehan’s syndrome. If the patient also has pituitary hormone deficiency, the condition is called panhypopituitarism. The etiology of the disease is complex, and various lesions of the hypothalamus, pituitary gland and adjacent tissues that involve the adenopituitary gland can cause the disease. The disease can be divided into two categories according to the location of the primary lesion: secondary hypopituitarism caused by hypothalamic pro-releasing hormone deficiency and primary hypopituitarism caused by the pituitary gland itself. The former is more common, while the latter includes simple GH deficiency, simple ACTH deficiency, simple LH/FSH deficiency and simple TSH deficiency, with simple GH deficiency being the most common. Multi-hormone deficiency hypopituitarism is also known as combined pituitary hormone deficiency (CPHD), and mono-hormone deficiency hypopituitarism is also known as isolated pituitary hormone deficiency. Primary hypopituitarism 1. Congenital: Some congenital developmental anomalies can cause pituitary gland dysplasia, resulting in a variety of pituitary hormone deficiencies. These diseases include anencephaly, holoprosencephaly, de Morsier syndrome, Hall-Pallister syndrome and Reiger syndrome. The forebrain anomalies include cyclopia, cebocephaly, and orbital hypotelorism. de Morsier syndrome is also known as septal-optic dysplasia, in which the septum pellucidum is absent. de MorsieI syndrome is caused by inactivating mutations in the Hesx-1 gene. de Motsier syndrome patients have abnormal hypothalamic development, resulting in hypopituitarism, of which GH Hall-Pallister syndrome also has pituitary hypoplasia or even pituitary agenesis, and may be associated with hypothalamic hamartoblastoma. The syndrome is associated with hypothalamic misshapen embryonic cell tumor (hamartoblastoma). In addition to pituitary hypoplasia, Reiger syndrome also has iris defects, glaucoma and abnormalities of the kidneys, gastrointestinal tract and umbilicus, which are caused by mutations in the Ptx-2 gene. In addition, cleft lip and cleft palate can be combined with GH deficiency. According to foreign data, about 4% of cleft lip and cleft palate patients have GH deficiency. Mutations in the transcription factors Pit-1 and Prop-1 can also cause pituitary hypoplasia, resulting in deficiencies of various pituitary hormones. In addition, mutations in some pituitary hormone genes can cause deficiencies of the corresponding hormones. For example, mutation of GH-1 gene can cause GH deficiency. 2, pituitary tumor: pituitary tumor is the most common cause of this disease. Pituitary adenoma is the most common pituitary tumor. All kinds of pituitary adenomas can cause hypopituitarism by compressing the normal pituitary tissue and pituitary stalk. Non-functioning adenomas are not obvious in terms of hormonal hypersecretion and are most likely to cause hypopituitarism. Other pituitary tumors and tumors of adjacent pituitary tissues can also cause hypopituitarism, including craniopharyngioma, Rathke’s cyst, dermatomal cyst, ganglioneuroblastoma, paraganglioma, nasal glioma (esthesioneuroblastoma), sarcoma, lipoma, hemangiopericytoma ( hemangiopericytoma), embryonal cell tumor, etc. 3, pituitary stroke: pituitary stroke refers to ischemic necrosis or hemorrhage of pituitary tissue. Pituitary tumors and postpartum hemorrhage are the most common causes of pituitary strokes. Atherosclerosis, especially in combination with diabetes, is also prone to pituitary strokes. The secretion function of the pituitary gland is reduced after a stroke, which causes the disease. 4, infection: bacterial (pituitary tuberculosis, pituitary abscess, etc.), fungal, viral (encephalitis, epidemic hemorrhagic fever, etc.) and spirochete (syphilis, etc.) infections can cause hypopituitarism. 5, infiltrative lesions: some infiltrative lesions such as hemochromatosis, nodular disease, Wegener’s granuloma, etc. can involve the pituitary gland, thus causing hypopituitarism. Lymphocytic pituitaryitis is also an infiltrative lesion. 6, pituitary trauma: pituitary trauma can damage the pituitary tissue and cause hypofunction. 7, pituitary surgery: excessive removal of pituitary tissue during pituitary surgery or excessive surgical damage to the pituitary gland can cause hypopituitarism. 8.Radiation injury: radiation treatment of pituitary tumors with high dose is very likely to cause hypopituitarism, and its incidence increases year by year with time. Radiation therapy for other intracranial or extracranial tumors can also produce hypopituitarism. 9, other diseases: empty saddle syndrome, internal carotid aneurysm, cavernous sinus thrombosis, etc. can also cause hypopituitarism. 10, idiopathic: idiopathic hypopituitarism (idiopathic hypopituitarism) etiology is unknown. MRI shows that the pituitary gland and pituitary stalk are small.