Panhypopituitarism in an Elderly Patient: A Case Report of Pituitary Macroadenoma Presenting With Sepsis-Like Symptoms

Panhypopituitarism is uncommon but clinically significant, most often caused by pituitary macroadenomas. Its presentation can be subtle and nonspecific, which may lead to misdiagnosis, particularly in elderly patients. We report the case of an 85-year-old woman admitted with fever, abdominal pain, hypotension, and acute confusion, initially managed as sepsis. Laboratory tests revealed hyponatremia and multiple anterior pituitary hormone deficiencies. Magnetic Resonance Imaging (MRI) confirmed a pituitary macroadenoma with suprasellar extension. The patient showed rapid clinical improvement after initiation of hydrocortisone and levothyroxine replacement. Ophthalmologic evaluation demonstrated preserved visual function, supporting conservative management. This case underscores the importance of considering endocrine causes, especially adrenal insufficiency due to pituitary disease, in elderly patients presenting with sepsis-like symptoms. Early recognition and timely hormone replacement can be life-saving.