Presentation
PowerPoint Presentation: BY: Minyahil Alebachew (Clinpharm. [authorstream.com]
Symptoms may not be present and tumours can be found when imaging is performed for other reasons (incidentalomas). [labtestsonline.org.uk]
Published on Jul 17, 2017 Presented by: Linda M. [youtube.com]
If findings are suggestive that a tumor may be present, a pituitary magnetic resonance imaging ( MRI) examination may be ordered. [empoweryourhealth.org]
Entire Body System
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Myxedema
Myxedema coma can result in death. Complications: Myxedema coma, the most severe form of hypothyroidism, is rare. It may be precipitated by an infection, illness, exposure to cold, or certain medications. [uclahealth.org]
cretinism in children, problems culminating in myxedema in adults). Loss of ACTH produces secondary adrenal insufficiency, which is just as deadly as primary adrenal insufficiency. [pathguy.com]
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Male Hypogonadism
In women, prolactinoma might cause: Irregular menstrual periods Lack of menstrual periods Milky discharge from the breasts In men, a prolactin-producing tumor may cause male hypogonadism. [mayoclinic.org]
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Short Stature in Children
Conversely, reduced amounts of GH can cause growth hormone deficiency syndrome in adults and children, (characterized by short stature in children). [acromegaly.org]
TREATMENT (synthetic GHRH ): TREATMENT (synthetic GHRH ) A synthetic GHRH product known as sermorelin ( Geref ) currently is FDA approved for the treatment of idiopathic GH deficiency( non- GHD short stature) in children. [authorstream.com]
Respiratoric
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Hypoventilation
[…] signal down from the brain to tell us to breathe at night time can go a little awry and that’s something called “central sleep apnoea” and there are complex interactions in people when they carry a bit much weight as well and we know that it’s obesity hypoventilation [sleephub.com.au]
Jaw & Teeth
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Widely Spaced Teeth
Patients also have coarse facial features and widely spaced teeth. Other symptoms include muscle weakness, profuse sweating, and thickened skin. Cushing syndrome - This disorder is marked by high levels of cortisol. [docdoc.com.sg]
Musculoskeletal
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Increased Muscle Mass
GH decreases utilization of glucose by peripheral tissues, increases lipolysis, and increases muscle mass. [authorstream.com]
Face, Head & Neck
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Frontal Bossing
Head, eyes, ears, nose, and throat (HEENT): frontal bossing, prognathism and macroglossia can indicate excess growth hormone. Neurological: visual field deficits and cranial nerve palsies can indicate mass effect from a pituitary lesion. [cancertherapyadvisor.com]
Laron dwarves (short, frontal bossing; the defect is in the growth hormone receptors; update J. Clin. Endo. 83 : 4481, 1998). [pathguy.com]
Urogenital
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Amenorrhea
FSH / LH lost Decreased Libido / Amenorrhea 3. [quizlet.com]
decreased libido (males) Prolactin Infertility, amenorrhea/galactorrhea (females), decreased libido (males) Oligomenorrhea, inability to lactate (females), decreased sexual function, loss of facial or body hair 2. [clinicaladvisor.com]
Hyperprolactinemia causes milk discharge from the breast (galactorrhea), menstrual irregularities (oligomenorrhea or amenorrhea) and infertility in women and impotence in men. [emoryhealthcare.org]
They may cause discharge from breasts (galactorrhea), irregular periods (oligomenorrhea) or loss of normal menstrual function (amenorrhea) in females and impotence in men. [my.clevelandclinic.org]
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Sexual Dysfunction
Low levels of pituitary hormones can cause many symptoms such as fatigue, sexual dysfunction and changes in body composition, appearance or weight. [uchicagomedicine.org]
Common symptoms of pituitary disorders include loss of vision, fatigue, weakness, headaches, nausea, sexual dysfunction, or weight gain or loss. [sharecare.com]
Some of the more common symptoms of pituitary disorders include: Headaches Visions problems, especially peripheral vision issues Fatigue Dizziness Dry skin Irregular periods Sexual dysfunction Unexpected weight gain or weight loss Excessive urination [intermountainhealthcare.org]
Too much or too little of certain hormones may also cause the following symptoms: Muscle weakness Less frequent or no menstrual periods Body hair loss Sexual dysfunction and infertility Increased frequency and amount of urination Excessive thirst Unintended [froedtert.com]
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Secondary Amenorrhea
Estrogen deficiency in approximately 50% of premenopausal women with secondary amenorrhea is attributable to acquired gonadotropin-releasing hormone (GnRH) dysregulation, comprising hyperprolactinemia. [hindawi.com]
N Engl J Med 2010; 363:365-371 A 16-year-old girl presents for evaluation of secondary amenorrhea. Her menarche was at the age of 12 years. Her last menstrual period was 6 months ago. [nejm.org]
Workup
It is more likely that hospitalists will encounter an incidental finding of a pituitary lesion during workup for other reasons. [clinicaladvisor.com]
Andrew Schorr: So what is the workup? What should they be asking for when there's been no other cause? Dr. Lewis Blevins: I think to start with, patients should just raise the issue. [ucsfhealth.org]
The lab workup of acromegaly is straightforward. Your screening test is a spot blood insulin-like growth factor I (IGF-I). If this is normal, acromegaly is unlikely. [pathguy.com]
When Cushing syndrome is considered, several variations in the diagnostic workup, when compared to that for nonpregnant women, may be necessary. [emedicine.medscape.com]
Serum
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Cortisol Increased
We then draw blood from the IV to see if the levels of growth hormone or cortisol increase as we would expect. [chw.org]
The increase in total serum cortisol is partly due to an increase in cortisol-binding globulin, but the unbound or free cortisol increases as well. [emedicine.medscape.com]
Treatment
For pituitary disorders not caused by a tumor: Treatment typically consists of medication. When the diagnosis is a tumor: Treatment may include medication. [henryford.com]
Treatment Options Medical Treatments Surgical Treatments [emoryhealthcare.org]
Surgical treatment plans may include: • Endoscopic Transsphenoidal surgery • State-of-the-art Cyberknife Radiosurgery These treatments may be used as a stand-alone treatment or in combination with other non-surgical treatments. [health.usf.edu]
The Pituitary Center provides comprehensive multidisciplinary care for the evaluation and treatment of pituitary tumors and neuroendocrine disorders. [ucdenver.edu]
And our commitment to personalized care means preserving your quality of life is at the heart of your treatment. Nationally recognized leader City of Hope is nationally recognized as a leader in the research and treatment of pituitary disorders. [cityofhope.org]
Prognosis
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]
Sparsely Granulated Fibrous bodies made of Keratin 8 - FAST Growing tumor Gigantism in kids / teens - Crippled by nerve, muscle, joint problems - Acromegaly develops post-puberty Acromegaly Arthritis / Joint Deformities - Good prognosis with therapy - [quizlet.com]
What Is the Prognosis for Hypopituitarism? With appropriate treatment, the prognosis is very good. [emedicinehealth.com]
Prognosis The prognosis for most patients with hypopituitarism is excellent. As long as therapy is continued, many experience normal life spans. [medical-dictionary.thefreedictionary.com]
Etiology
Understand basics of “trauma” and its potential role in the etiology of some pituitary disorders. Know how the medical/physiological aspects of pituitary tumors and other pituitary disorders can interact and affect the mental health of patients. [youtube.com]
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. [cancertherapyadvisor.com]
Etiological diagnosis of hyperprolactinemia. Ann Endocrinol (Paris). 2007 Jun;68(2-3):98-105. Epub 2007 May 23.. Endocrine and Metabolic Diseases Information Service.. Gsponer J, De Tribolet N, Deruaz JP, et al. [naturallivingcenter.net]
Little is known of the etiology or genetics (J. Neurosurg. 98 : 162, 2003). Grossly, most of these tumors usually filled with little cysts that contain an unsavory, cholesterol-rich fluid ("machine oil"). [pathguy.com]
Epidemiology
Epidemiologic studies will be undertaken to determine the status of recipients of hGH. [cdc.gov]
Disorders August 2011 Contents: Contents Anterior Pituitary Disorders GH disorders Gigantism (child) Acromegaly (adult) Prolactin hormone disorders Hyperprolactemia Posterior Pituitary Disorders ADH disorders DI SIADH Objectives: Objectives To discuss the epidemiology [authorstream.com]
Pathophysiology
Rizzo Journal of Neuro-Ophthalmology. 2016; 36(3): 313 8 Revisitation of autoimmune hypophysitis: knowledge and uncertainties on pathophysiological and clinical aspects Giuseppe Bellastella,Maria Ida Maiorino,Antonio Bizzarro,Dario Giugliano,Katherine [ijem.in]
Pharmacotherapy A Pathophysiologic Approach. Seventh Edition ed.: McGraw-Hill; 2008. Curtis L. Triplitt CAR, and William L. Isley. PHARMACOTHERAPY A Pathophysiologic Approach. Sixth Edition ed. Joseph T. [authorstream.com]
Study group of the Italian Society of Endocrinology on the pathophysiology of the hypothalamic-pituitary-adrenal axis. J Clin Endocrinol Metab 1999;84:440–8. Retrospective multicentre study of 426 patients with Cushing’s syndrome. [jnnp.bmj.com]
[…] pituitary { 02294 } anterior pituitary, histology; curious stain, don't worry about the colors { 14948 } posterior pituitary, histology (arrow: Herring body) OBJECTIVES; Know when to suspect each of these clinical syndromes, and give the likely etiologies, pathophysiology [pathguy.com]
Prevention
There are no specific ways to prevent pituitary disorders or tumors. If you have a family history of pituitary disorders, increased screening and testing is recommended to catch tumors early and prevent complications. [intermountainhealthcare.org]
It can also prevent women from producing milk when they are pregnant or breastfeeding. Who to See and Types of Treatments Available Disorders of the pituitary gland are treated by endocrinologists. [docdoc.com.sg]
(ADH), which causes frequent urination and excessive thirst Hypopituitarism: the pituitary gland doesn't produce one or more of the hormones it normally produces Prolactinoma: a pituitary gland tumor that causes too much prolactin hormone, which can prevent [umiamihealth.org]
Provocative/suppression test Drugs or hormones artificially stimulate or prevent you from producing certain hormones so your doctor can see how your body reacts. Our endocrinologists and nurses are specialized in pituitary provocative testing. [dukemedicine.org]
Hormone blood tests can be taken randomly for some hormones, but others may require specialised testing with substances that should provoke the release or prevent release in certain conditions. [patient.info]