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]
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
- 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]
Cardiovascular
- Systolic Murmur
Auscultate heart sounds, note extra heart sounds, development of gallops and systolic murmurs. Monitor ECG, noting rate and rhythm. [slideshare.net]
Jaw & Teeth
- 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]
Skin
- Skin Patch
People with this syndrome tend to have brown skin patches and bone problems. Pituitary tumor symptoms Symptoms of pituitary tumors depend on which part of the gland and what hormone (if any) is being released. [cityofhope.org]
Urogenital
- 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]
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]
- 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]
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]
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]
- 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
- 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]
- Eosinophils Decreased
Poor healing. 31. Plasma cortisol level—increased(Morning 5-23 micrograms per deciliter (mcg/dL, Afternoon 3-16 mcg/dL ) Blood glucose level—increased. Serum potassium level—decreased(3.5-5.2 milliequivalents per liter (mEq/L) Eosinophils—decreased [slideshare.net]
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]
The Pituitary Center provides comprehensive multidisciplinary care for the evaluation and treatment of pituitary tumors and neuroendocrine disorders. [ucdenver.edu]
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]
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]
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]
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]
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
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]
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]
(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]