Presentation
Stress-related hypogonadotropic hypogonadism presents in women as amenorrhea. [emedicine.medscape.com]
Females present with primary amenorrhea, and some males present with micropenis. Kallmann syndrome results from the congenital absence of GnRH-producing neurons in the hypothalamus. [thehealthscience.com]
This revised edition of Charles Brook's Handbook of Clinical Pediatric Endocrinology provides endocrinologists and pediatricians in training with a fully up-to-date clinical guide presenting evidence-based practice in the diagnosis, treatment, and management [books.google.com]
Abstract: A case report of an 18-year-old male with luteinizing hormone (LH) deficiency in hereditary congenital adrenal hypoplasia, probably of the cytomegalic type, is presented. [popline.org]
Entire Body System
- Infertility
Men with infertility related to pituitary dysfunction are often cared for by urologists who specialize in infertility. Men or women with panhypopituitarism are cared for by medical endocrinologists. [emedicine.medscape.com]
He presented with absent pubertal development and primary infertility. His parents have consanguinity and elder sister has primary infertility. He was 185 cm tall and thin (BMI 18 kg/m 2 ) with arm span of 196 cm and lower segment 102 cm. [endocrine-abstracts.org]
Both can cause several untoward conditions such as infertility, impotence, osteoporosis of bone, bone fractures, etc. [tandurust.com]
- Precocious Puberty
Disorders of Pubertal Development: Precocious Puberty. From Seminars in Reproductive Medicine 21(4):339-351 from Medscape. Available online at http://www.medscape.com/viewarticle/468259. [labtestsonline.it]
It is also often helpful in the evaluation of precocious or delayed puberty. [labtestsonline.org]
In contrast, constant administration of GnRH suppresses gonadotropin secretion, which has therapeutic benefits in certain patients, such as children with precocious puberty and men with prostate cancer. [britannica.com]
This is known as precocious puberty. According to the American Association of Clinical Chemistry (AACC), girls are more likely to experience this condition than boys. [healthline.com]
- Male Hypogonadism
Irvin Hirsch, Male Hypogonadism, Merck Manuals Dec 2014 [dontcookyourballs.com]
Male Hypogonadism. ARUP Consult. Available online at https://arupconsult.com/content/hypogonadism-male?_ga=2.126530189.1479446145.1525530915-171446445.1522145782. Accessed on 5/05/19. Vogiatzi, M. (2018 February 11, Updated). Hypogonadism. [labtestsonline.it]
Male hypogonadism due to a mutation in the gene for the beta-subunit of follicle-stimulating hormone. N Engl J Med. 1998 Jun 11. 338(24):1729-32. [Medline]. Kalantaridou SN, Makrigiannakis A, Zoumakis E, Chrousos GP. [emedicine.medscape.com]
- Tall Stature
Signs and symptoms of excess GH In children (gigantism): Abnormally rapid growth Very tall stature Painful joints Excessive sweating. [innerbody.com]
Gastrointestinal
- Nausea
Symptoms Symptoms are usually acute and include severe headache, ophthalmoplegia (paralysis of the eye muscles causing double vision), and symptoms of acute adrenal insufficiency (low blood pressure, nausea, and vomiting). [medicine.georgetown.edu]
With gradual onset of deficiency over days or weeks, symptoms are often vague and may include weight loss, fatigue, weakness, depression, apathy, nausea, vomiting, anorexia and hyperpigmentation. [pituitary.org]
ACTH deficiency : Symptoms include fatigue, low blood pressure, weight loss, weakness, depression, nausea, or vomiting. TSH deficiency: Symptoms include constipation, weight gain, sensitivity to cold, decreased energy, and muscle weakness or aching. [webmd.com]
Macroadenomas Large pituitary adenomas may cause headaches, nausea, and vomiting. Compression of the optic chiasm causes loss of peripheral vision. [innerbody.com]
(Analysis 1.6) Gastrointestinal toxicity There may be little or no difference in the risk of nausea and vomiting between women who received leuprorelin and those who received treosulfan (RR 0.65, 95% CI 0.12 to 3.66, P value = 0.62). [cochranelibrary.com]
- Vomiting
Symptoms Symptoms are usually acute and include severe headache, ophthalmoplegia (paralysis of the eye muscles causing double vision), and symptoms of acute adrenal insufficiency (low blood pressure, nausea, and vomiting). [medicine.georgetown.edu]
With gradual onset of deficiency over days or weeks, symptoms are often vague and may include weight loss, fatigue, weakness, depression, apathy, nausea, vomiting, anorexia and hyperpigmentation. [pituitary.org]
ACTH deficiency : Symptoms include fatigue, low blood pressure, weight loss, weakness, depression, nausea, or vomiting. TSH deficiency: Symptoms include constipation, weight gain, sensitivity to cold, decreased energy, and muscle weakness or aching. [webmd.com]
Macroadenomas Large pituitary adenomas may cause headaches, nausea, and vomiting. Compression of the optic chiasm causes loss of peripheral vision. [innerbody.com]
Physical findings in patients suffering from anorexia or bulimia can include lanugo (fine, soft, lightly pigmented hair), dry skin, and/or poor dental enamel from excessive vomiting. [emedicine.medscape.com]
- Failure to Thrive
If the problem is chronic, symptoms consist of fatigue, weight loss, failure to thrive (in children), delayed puberty (in adolescents), hypoglycemia (low blood sugar levels), anemia and hyponatremia (low sodium levels). [en.wikipedia.org]
Musculoskeletal
- Osteoporosis
If untreated, resulting hypogonadism also puts patients at risk for medical conditions associated with low testosterone in males and low estrogen in females, including osteoporosis and bone fractures. Race LH deficiency occurs in all races. [thehealthscience.com]
Treatment with recombinant GH could lead to improvements in height in children, as well as other physical (eg, obesity, hyperlipidemia, osteoporosis, reduced renal function) and psychological (fatigue and diminished sense of well-being) parameters in [jhu.pure.elsevier.com]
[…] low stamina) Reduced muscle strength Increased body fat Decreased libido (low interest in sex) Difficulty getting and keeping erections (uncommon) Low semen volume Reduced beard or body hair growth Gynecomastia (breast development) Hot flushes, sweats Osteoporosis [andrologyaustralia.org]
Both can cause several untoward conditions such as infertility, impotence, osteoporosis of bone, bone fractures, etc. [tandurust.com]
Psychiatrical
- Suggestibility
Ovariectomy led to increased amounts of FSH-beta but not LH-beta messenger RNA, which suggested a pituitary defect. [ncbi.nlm.nih.gov]
Ovariectomy led to increased amounts of FSH-β but not LH-β messenger RNA, which suggested a pituitary defect. [science.sciencemag.org]
Weakness, hypoglycemia, weight loss, and decreased axillary and pubic hair suggest the diagnosis. Blood and urinary steroid levels are low and rise to normal after ACTH replacement. [merckmanuals.com]
Low IGF-1 levels in the setting of hypothalamic-pituitary disease suggest GHD. Low IGF-1 may also result from causes other than GHD, such as malnutrition, diabetes, hypothyroidism, or liver disease. [ajmc.com]
Sergent for helpful criticism and suggestions, to Ms. Hancock and the staff of the Vanderbilt University Clinical Research Center for their constant help and support, and to Dr. [nejm.org]
Neurologic
- Stroke
Heart Due to estrogen depletion, women are put at an increased risk for cardiovascular issues, such as heart attacks, strokes, or other heart-related problems. [menopause.northwestern.edu]
Other forms of stroke are increasingly recognized as a cause for hypopituitarism. [en.wikipedia.org]
People who have hypopituitarism a long time have a slight shorter life span due to vascular causes, such as heart attacks and stroke, and infections. [draxe.com]
Urogenital
- Primary Amenorrhea
HH24 is characterized by primary amenorrhea in women, oligo or azoospermia with low to normal testosterone levels in men, and infertility. {ECO:0000269 PubMed:8220432, ECO:0000269 PubMed:9271483, ECO:0000269 PubMed:9280841}. [genecards.org]
WE have previously described the clinical features of a 22-year-old woman who was evaluated in 1971 for primary amenorrhea and in whom we established the diagnosis of isolated deficiency of follicle-stimulating hormone (FSH). 1, 2 Serum FSH levels were [nejm.org]
Females present with primary amenorrhea, and some males present with micropenis. Kallmann syndrome results from the congenital absence of GnRH-producing neurons in the hypothalamus. [thehealthscience.com]
Female patients also give a history of primary amenorrhea. In children, idiopathic hypogonadotropic hypogonadism (IHH) can present identical to Kallmann syndrome, but without anosmia. [emedicine.medscape.com]
- Vaginal Dryness
dryness in women difficulty in conceiving infertility. [news-medical.net]
Vagina Low estrogen levels can lead to vaginal dryness, irritation or discomfort. [menopause.northwestern.edu]
Women may also have premature cessation of menstruation, hot flashes, vaginal dryness and pain during intercourse. Women who are postmenopausal will not have obvious symptoms such as these and may first present with headache or loss of vision. [altered-states.net]
Workup
Consider MRI if workup suggests hypothalamic or pituitary mass or other abnormality (eg, abnormal pituitary hormone levels, visual field lesions, or neurologic signs). Testicular ultrasound if testicular masses are detected on examination. [hiv.va.gov]
In both women and men, LH is often used in conjunction with other tests ( FSH, testosterone, estradiol and progesterone ): In the workup of infertility To aid in the diagnosis of pituitary disorders that can affect LH production To help diagnose conditions [labtestsonline.org]
Treatment
This revised edition of Charles Brook's Handbook of Clinical Pediatric Endocrinology provides endocrinologists and pediatricians in training with a fully up-to-date clinical guide presenting evidence-based practice in the diagnosis, treatment, and management [books.google.com]
Treatment Medical Care Hypogonadotropic hypogonadism Treatment of hypogonadotropic hypogonadism depends on the gender and age of the patient as well as their desire for current fertility. [emedicine.medscape.com]
More studies are needed in infertile male patients with LH variants to demonstrate if recombinant LH or hCG treatment could be beneficial in selected populations. [austinpublishinggroup.com]
Measures of treatment effect We used the following measures of the effect of treatment. [cochranelibrary.com]
Apart from the demographic data, anamnestic details e.g. reason for the infertility, duration of the unfulfilled wish for children, past medical treatment for conception and accompanying illnesses will be documented. [clinicaltrials.gov]
Prognosis
Improving the criteria for POR, with a stratification that incorporates prognosis for pregnancy, may help to improve ART success rates for women with this condition. [excemed.org]
Outlook (Prognosis) Acute pituitary infarction is a potentially life-threatening event. Prognosis for chronic deficiency (which is detected and treated) is good. [medicine.georgetown.edu]
What Is the Prognosis for Hypopituitarism? With appropriate treatment, the prognosis is very good. [emedicinehealth.com]
What is the prognosis for a person with PROP1-related Combined Pituitary Hormone Deficiency? People with PROP1-related CPHD are typically able to live a normal lifespan. [counsyl.com]
Outlook If hormone replacement therapy is adequate, the prognosis is good. Complications are often related to the underlying disease. For More Information Visit the Pituitary Network Association web site. [webmd.com]
Etiology
The final section describes the different etiologies of GH deficiency, from molecular mechanisms and gene abnormalities to cranial radiation and traumatic brain injury, along with syndromes related to this deficiency. [books.google.com]
They are organised into groups, and further divided into clinical, etiological or histopathological sub-types. [orpha.net]
When considering pathology related to the pituitary itself, the most common etiology of either over- or under-production of pituitary hormones in adults is a pituitary lesion. [clinicaladvisor.com]
Although these 421 patients were only screened for KAL1, this result implies that KAL1 mutations only contribute to CPHD/SOD etiology to a minor extent, if any. [nature.com]
Further, the extent of excessive visceral fat is negatively correlated with GH production, whereas exercise appears to be positively correlated. 2 There are many different etiologies for GHD in adults. [ajmc.com]
Epidemiology
Epidemiology Hypopituitarism is a rare disorder that affects less than 200,000 individuals in the United States, with an incidence of 4.2 cases per 100,000 people per year. [news-medical.net]
Genatlas disease for FSHB Gene delayed puberty,primary amenorrhea,infertility (FSH deficiency,isolated),hypogonadism in man Relevant External Links for FSHB Genetic Association Database (GAD) FSHB Human Genome Epidemiology (HuGE) Navigator FSHB Atlas [genecards.org]
Whether this condition results from inadequate LH secretion to stimulate progesterone production by the corpus luteum or an inadequate response of the corpus luteum to appropriate LH stimulation is unclear. [7, 8, 12] Epidemiology Frequency United States [thehealthscience.com]
It has been shown that the degree of elevation in lipid level 3 and the severity of bone mineral loss correlate with the severity of GHD. 4 Epidemiologic studies have clearly shown that adults with hypopituitarism, including GHD, display an increased [ajmc.com]
Epidemiology Frequency United States Hypogonadotropic hypogonadism has an overall incidence of approximately 1:10,000 to 1:86,000 men and women. Two thirds of the time, this is associated with anosmia (ie, Kallmann syndrome). [emedicine.medscape.com]
Pathophysiology
[…] disease/hypopituitarism/overview.html http://www.mayoclinic.org/diseases-conditions/hypopituitarism/home/ovc-20201485 Further Reading Hypopituitarism Diagnosis Hypopituitarism Treatment Hypopituitarism Causes Hypopituitarism Epidemiology Hypopituitarism Pathophysiology [news-medical.net]
Clinically, only FSH is used as a marker of testicular dysfunction. [4] Pathophysiology Hypothalamic causes of LH deficiency Kallmann syndrome Kallmann syndrome was first described by Franz Hosef Kallmann in 1944 and refers to congenital secondary hypogonadism [thehealthscience.com]
Pathophysiology [ edit ] The pituitary gland is located at the base of the brain, and intimately connected with the hypothalamus. [en.wikipedia.org]
Prevention
Seite 142 - Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. [books.google.de]
Plate sealers not used or reused Cover assay plate with plate sealer, use a fresh sealer each time to prevent contamination [biovision.com]
Prevention Pituitary adenomas are not associated with any known lifestyle or environmental risk factors, so there are no available methods to prevent the condition. [innerbody.com]
Getting pregnant requires that the delicate balance of hormones is intact; any disturbance in the hormone balance can result in menstrual difficulties that prevent pregnancy. [livestrong.com]
● A deficiency in GH prevents somatic growth throughout the body. [quizlet.com]