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Luteinizing Hormone Deficiency

Luteinising Hormone Deficiency


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]
  • 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]
  • Presenting underlying mechanisms and pathologies, as well as diagnostic methods, Growth Hormone Deficiency will provide the most up-to-date essential information and evidence on this condition for the clinical endocrinologist.[books.google.com]
Male Hypogonadism
  • 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]
  • Irvin Hirsch, Male Hypogonadism, Merck Manuals Dec 2014[dontcookyourballs.com]
  • hypogonadism, and estradiol for female hypogonadism (usually with a progestogen to inhibit unwanted effects on the uterus ).[en.wikipedia.org]
Tall Stature
  • Signs and symptoms of excess GH In children (gigantism): Abnormally rapid growth Very tall stature Painful joints Excessive sweating.[innerbody.com]
Bulimia
  • Bulimia nervosa typically presents with menstrual irregularities and oligomenorrhea. Patients with anorexia and bulimia may also present with depressive episodes, social withdrawal, and other psychosocial disturbances.[emedicine.medscape.com]
  • Stress-related hypothalamic suppression is most commonly related to prolonged strenuous physical exercise and extreme weight loss, particularly in the context of eating disorders, such as anorexia nervosa and bulimia. [9] These conditions cause an elevation[thehealthscience.com]
Lanugo
  • 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]
Long Arm
  • The alpha subunit is composed of 92 amino acids and is encoded on the long arm of chromosome 6. The beta subunit is 121 amino acids and is encoded on the long arm of chromosome 19.[thehealthscience.com]
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]
  • 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]
  • 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]

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]
Testosterone Increased
  • In the good response group, serum luteinizing hormone and follicle-stimulating hormone levels increased to the normal range, total serum testosterone increased from 0.29 nmol/L to 8.67 nmol/L ( P .00002), and testicular volume increased from 3.3 mL to[healio.com]

Treatment

  • 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]
  • Luteinizing Hormone Deficiency Treatment Treatment options can be directed at the hypogonadism on its own or the pituitary dysfunction.[healthhype.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]
  • 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]
  • Treatment For Luteinizing Hormone Deficiency Treatment of luteinizing hormone deficiency can be focused on treating hypogonadism as well as treating pituitary dysfunction.[tandurust.com]

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]
  • Long-term prognosis in anorexia nervosa: lessons from a 21-year follow-up study. Lancet. 2000 Feb 26. 355(9205):721-2. [Medline]. Cahill DJ, Wardle PG, Harlow CR, Hull MG.[emedicine.medscape.com]
  • 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]

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

  • 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]
  • References Further Reading Hypopituitarism Diagnosis Hypopituitarism Treatment Hypopituitarism Causes Hypopituitarism Epidemiology Hypopituitarism Pathophysiology[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]
  • 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]
  • 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]
Sex distribution
Age distribution

Pathophysiology

  • 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]
  • References Further Reading Hypopituitarism Diagnosis Hypopituitarism Treatment Hypopituitarism Causes Hypopituitarism Epidemiology Hypopituitarism Pathophysiology[news-medical.net]
  • Pathophysiology [ edit ] The pituitary gland is located at the base of the brain, and intimately connected with the hypothalamus.[en.wikipedia.org]

Prevention

  • If estradiol is started within 10 years of menopause, it can prevent spine and hip bone fractures. Estradiol also promotes puberty. Ovulation induction agents (like follitropin alfa, clomiphene citrate) promote ovulation.[healthhype.com]
  • Seite 142 - Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. ‎[books.google.de]
  • Women who do not desire pregnancy are treated with estrogen to prevent osteoporosis.[emedicine.medscape.com]
  • 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]

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