EPO and hypopituitarism: Some patients with hypopituitarism may also show anemia, thrombocytopenia, pancytopenia, and coagulation disorders.[5] Cortisol and thyroid hormone deficiencies are involved in the development of anemia by lowering erythropoietin synthesis of erythropoietin.[6] The patient in our case had respiratory and circulatory failure symptoms, which were attributed to bilateral chest cavity effusion, ascites, and pericardial tamponade, which was confirmed by ultrasound B. The cause of multiple-cavity effusion could be due to a deficiency of hypothyroidism and low albumin levels.