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Pituitary Disorder

Diseases Pituitary


Presentation

  • If findings are suggestive that a tumor may be present, a pituitary magnetic resonance imaging ( MRI) examination may be ordered.[empoweryourhealth.org]
  • Pituitary conditions often develop very slowly and, in many cases, symptoms have been present for months or even years by the time a diagnosis is made.[cafamily.org.uk]
  • Caused by Carcinoma in Lung / other organs - Excessive ADH secreted by Tumor (Ectopic ADH Production) - Results in severe water retention by kidneys Clinical Presentation: - Headache / Vomit - NO Edema / HTN Labs: - Hyponatremia: 115-120 mEq/L Confusion[quizlet.com]
  • In the inpatient setting, however, it is important to keep in mind that patients may not present with complaints related to pituitary hormone dysfunction or neurological symptoms, or if they do, symptoms can be vague.[clinicaladvisor.com]
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]
  • Myxedema coma Euthyroid sick syndrome Hyperthyroidism Hyperthyroxinemia Thyroid hormone resistance Familial dysalbuminemic hyperthyroxinemia Hashitoxicosis Thyrotoxicosis factitia Graves' disease Thyroid storm Thyroiditis Acute infectious Subacute De[en.wikipedia.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]
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]
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]
Brittle Hair
  • Hypothyroidism can result in fatigue, constipation, dry skin, brittle hair, poor growth, feeling cold all the time, and disruptions to normal periods in girls.[chw.org]
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.[clinicaladvisor.com]
  • Laron dwarves (short, frontal bossing; the defect is in the growth hormone receptors; update J. Clin. Endo. 83 : 4481, 1998).[pathguy.com]
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]
  • 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]
  • Hyperprolactinemia causes milk discharge from the breast (galactorrhea), menstrual irregularities (oligomenorrhea or amenorrhea) and infertility in women and impotence in men.[emoryhealthcare.org]
Sexual Dysfunction
  • 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]
  • 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]
Secondary Amenorrhea
  • 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]
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

  • The Pituitary Center provides comprehensive multidisciplinary care for the evaluation and treatment of pituitary tumors and neuroendocrine disorders.[ucdenver.edu]
  • Our treatment approach involves An initial consultation with an experienced pituitary disorder experts, providing accurate diagnosis, followed by a personalized treatment strategy Input from experts in various subspecialties at every stage of your treatment[cityofhope.org]
  • Cushing’s Syndrome Treatments Medications, Surgery, and Other Treatments for Cushing’s Syndrome Find out about common treatments for Cushing’s syndrome, such as surgery, radiation, and medications.[endocrineweb.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]
  • Support Groups: Expectations (prognosis): With early treatment, return to the normal state is usual. However, relapses will occur if the medication is not continued. Myxedema coma can result in death.[uclahealth.org]

Etiology

  • 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]
  • 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]
  • 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]
  • Although nonpregnant patients with an adrenal cause (most common in pregnancy) have undetectable ACTH levels, a detectable level of plasma ACTH does not exclude an adrenal etiology due to placental secretion of ACTH in pregnancy.[emedicine.medscape.com]

Epidemiology

  • Epidemiologic studies will be undertaken to determine the status of recipients of hGH.[cdc.gov]
Sex distribution
Age distribution

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]
  • 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]
  • 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]
  • This then prevents the effects of too much GH, such as overproduction of IGF-I. To do this pegvisomant binds to the natural receptors for growth hormone and gets in the way of the hormone being able to bind and send messages into cells.[pituitarysociety.org]
  • In many cases, people can live a normal life even with a pituitary disorder. 1 Answer A Pituitary disorders cannot be prevented. The cause of non-cancerous tumors of the pituitary gland, the most common form of the condition, is not known.[sharecare.com]

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