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]
Oxytocin is present in men but has no proven function. Click here for Patient Education NOTE: This is the Professional Version. [merckmanuals.com]
Published on Jul 17, 2017 Presented by: Linda M. [youtube.com]
Entire Body System
- 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]
Loss of thyrotropin produces secondary hypothyroidism (i.e., 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]
- 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]
- 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]
Clinical Presentation of Short Stature: Clinical Presentation of Short Stature Children with growth hormone (GH)-deficient or GH-insufficient short stature may also present with central obesity, prominence of the forehead, and immaturity of the face. [authorstream.com]
- Pallor
[…] feeling too hot, or too cold Nausea Mood swings feelings of depression, apathy or low mood Joint aches and pains, and/or poor muscle tone Exhaustion Constipation Difficulty finding words Poor sleep patterns Low blood pressure feeling light-heade Pale pallor [pituitary.org.uk]
Gastrointestinal
- Constipation
A high-fiber, low-calorie diet and moderate activity will help relieve constipation and promote weight loss if weight was gained during the time when thyroid activity was low. [uclahealth.org]
Other possible symptoms related to the pressure caused by a pituitary tumor: Cold intolerance Constipation Dry skin Headache Loss of hair on your body Low blood pressure Missed periods Nausea Sexual dysfunction Unexplained weight loss or gain Vomiting [endocrineweb.com]
[…] cold intolerance excessive perspiration (sweating) decreased appetite vision impairment, blurriness, blindness (particularly poor peripheral vision) excessive thirst and frequent urination growth failure delayed or premature puberty nausea dry skin constipation [pituitary.mgh.harvard.edu]
[…] upper back High or low blood pressure and high or low blood sugar Bruising and thinning of the skin Anxiety, irritability or depression Exaggerated facial features and enlarged hands and feet Excess sweating Heart problems Joint pain Cold intolerance Constipation [froedtert.com]
Eyes
- Diplopia
[…] muscle weakness exertional intolerance and shortness of breath oligomehnorrhea (decreased menstrual flow) nervousness and irritability other mental disturbances sleep disturbances (including insomnia) changes in vision, photophobia, eye irritation, diplopia [pituitary.mgh.harvard.edu]
Injury to cranial nerves 3,4,or 6 can cause diplopia (double vision). Compression of cranial nerve 5 can cause pain and numbness in the forehead and nose. There are specific simple bedside tests for optic chiasm disease. [houstonendocrine.com]
The patient's symptoms progressed to include swallowing difficulties, diplopia, and finally, dementia. He died in February 1985. No autopsy was done. [cdc.gov]
PITUITARY APOPLEXY Haemorrhage or infarction of the pituitary may be clinically benign or present catastrophically with severe headache, meningism, vomiting, reduction in visual fields, diplopia, impairment of consciousness, or death. [jnnp.bmj.com]
Psychiatrical
- Psychiatric Manifestation
In pituitary disease, one of the most common psychiatric manifestations is the presence of depressive symptoms significant enough to warrant diagnosis of a major depressive disorder.1 Cushing’s disease is probably the most frequently studied of the pituitary [neuro.psychiatryonline.org]
manifestations or later may appear after replacement of glucocorticoids. [102] There is limited data available on the prevalence of SS in general community. [ijem.in]
Urogenital
- Amenorrhea
FSH / LH lost = Decreased Libido / Amenorrhea 3. [quizlet.com]
Keywords: Prolactine, pituitary tumours, amenorrhea, lactorrhea, Dostinex. [yhth.vn]
Hyperprolactinemia causes milk discharge from the breast (galactorrhea), menstrual irregularities (oligomenorrhea or amenorrhea) and infertility in women and impotence in men. [emoryhealthcare.org]
Variants in such genes were detected in patients with hypothalamic amenorrhea. [nejm.org]
- 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]
Signs and symptoms include: Nausea and vomiting Weakness Feeling cold Less frequent or no menstrual periods Sexual dysfunction Increased amount of urine Unintended weight loss or gain Adrenocorticotropic hormone-secreting (ACTH) tumors ACTH tumors produce [mayoclinic.org]
Other possible symptoms related to the pressure caused by a pituitary tumor: Cold intolerance Constipation Dry skin Headache Loss of hair on your body Low blood pressure Missed periods Nausea Sexual dysfunction Unexplained weight loss or gain Vomiting [endocrineweb.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]
- Secondary Amenorrhea
Clinical Practice Jul 22, 2010 Functional Hypothalamic Amenorrhea Gordon C.M. | 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. [nejm.org]
Estrogen deficiency in approximately 50% of premenopausal women with secondary amenorrhea is attributable to acquired gonadotropin-releasing hormone (GnRH) dysregulation, comprising hyperprolactinemia. [hindawi.com]
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
- Hyperglycemia
Continued…<br />Signs and Symptoms<br />Huge stature : 7 or 8 feet height<br />Hyperglycemia, develop glycosuria, pituitary diabetes mellitus<br />Headache due to tumor of pituitary<br /> 10. [slideshare.net]
Somatotroph Adenoma (Gigantism + Acromegaly) Symptoms: - Increasing Shoe / Ring Size - Headache / Nausea / Vomit - Joint Pain / Neuropathy - Prognathism = Prominent Lower Jaw - Bitemporal Hemianopsia / Diabetic Retinopathy - Visceral Organ Growth Labs: - Hyperglycemia [quizlet.com]
(sweating) oily skin impotence Cushing's Disease (ACTH secreting adenoma): fat build-up in the face (round or moon face), back (characteristically the upper back causing a so-called hump), and chest, while the arms and legs to become relatively thin hyperglycemia [pituitary.mgh.harvard.edu]
- 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]
- 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]
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]
We develop a personalized treatment plan to restore hormone balance and relieve symptoms. The latest, research-backed treatments. [umiamihealth.org]
Seeking accurate diagnosis and effective treatment is essential in caring for pituitary disorders. The board-certified endocrinologists at UT Health provide reliable diagnosis and comprehensive treatment for all pituitary disorders. [uthscsa.edu]
TREATMENT (recombinant GH): TREATMENT ( recombinant GH) Replacement with recombinant GH is considered the mainstay of therapy for patients with GHD short stature, but its use for treatment of non-GHD short stature remains controversial, albeit such treatment [authorstream.com]
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]
Serum levels of pituitary hormones are lower than normal. hypopituitarism Endocrinology A condition characterized by ↓ secretion of one or more anterior pituitary or adenohypophyseal hormones Etiology Idiopathic, pituitary tumor, hypothalamic or infundibular [medical-dictionary.thefreedictionary.com]
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]
Epidemiologic aspects of postpartum pituitary hypofunction (Sheehan's syndrome). Fertil Steril 2005;84:523-8. 86. Dejager S, Gerber S, Foubert L, Turpin G. Sheehan's syndrome: Differential diagnosis in acute phase. J Intern Med 1988;244:261-6. 87. [ijem.in]
Pathophysiology
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. [jnnp.bmj.com]
Rizzo Journal of Neuro-Ophthalmology. 2016; 36(3): 313 [Pubmed] | [DOI] 8 Revisitation of autoimmune hypophysitis: knowledge and uncertainties on pathophysiological and clinical aspects Giuseppe Bellastella,Maria Ida Maiorino,Antonio Bizzarro,Dario Giugliano [ijem.in]
[…] 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
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]
Upstate Brain & Spine Center is recognized as a top performer in reducing the time between patient arrival and treatment — which is critical in minimizing the long-term effects of a stroke and even preventing death. [upstatebrainandspine.org]
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]
(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]
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]