Endocrine - Pituitary Gland 1 PDF

ELRAZI UNIVERSITY Faculty of Dentistry ENDOCRINE PATHOLOGY PITUITARY GLAND G. M. ELIMAIRI 1 Confusion ( hypoglycaemia, diabetic Hair loss(, hypothyroidism, ketoacidosis, hypothyroidism) hypopituitarism , hypoparathyroidism)...

ELRAZI UNIVERSITY Faculty of Dentistry ENDOCRINE PATHOLOGY PITUITARY GLAND G. M. ELIMAIRI 1 Confusion ( hypoglycaemia, diabetic Hair loss(, hypothyroidism, ketoacidosis, hypothyroidism) hypopituitarism , hypoparathyroidism) Dizziness (hypoglycaemia) Memory loss (hypothyroidism ) Episodic loss of consciousness ( Gradual loss of vision (diabetic hypoglycaemia) retinopathy) Flushing (hypoparathyroidism) Facial swelling(hypothyroidism ).hyperglycaemia , hypoglycaemia) Excessive sweating vomiting(hyperglycaemia , (hyperthyroidism., hypoglycaemia ) hypoglycaemia. ) palpitation(hypothyroidism ) Thirst DM. ) Acute shortness of breath Excessive urination (DM. ) (diabetic ketoacidosis. ) Tremor (hyperthyroidism ) tiredness(hypothyroidism ) Weight gain (hypothyroidism ) Loss of libido (hypothyroidism ) Weight loss (untreated type 1 COMMON CLINICAL DM. ) PROBLEMS FROM ENDOCRINE DISEASE  PATHOLOGICAL BASIS OF ENDOCRINE SIGNS & SYMPTOMS SIGNS OR SYMPTOMS PATHOLOGICAL BASIS OF HORMONE EXCESS ENDOCRINE GLAND HYPERPLASIA CAUSED (HYPERFUNCTION) BY INCREASED TROPHIC STIMULUS TO SECRETION FUNCTIONING NEOPLASM OF ENDOCRINE GLAND OF HORMONE DEFICENCY ENDOCRINE GLAND ATROPHY DUE TO (HYPOFUNCTION) LOSS OF TROPHIC STIMULUS TO SECRETION DESTRUCTION OF ENDOCRINE GLAND BY INFLAMMATION , ISCHAEMIA OR NON FUNCTIONING TUMOUR DIFFUSE ENLAGEMENT OF THE GLAND INFLAMMATORY CELL INFILTRATION HYPERPLASIA  PATHOLOGICAL BASIS OF ENDOCRINE SIGNS & SYMPTOMS SIGNS OR SYMPTOMS PATHOLOGICAL BASIS NODULAR ENLARGEMENT OF GLAND TUMOUR ( BENIGN OR MALIGNANT) SOME ORGAN SPECIFI FEATURE HEADAHE , BITEMPORAL HEMIANOPIA PITUITARY GLAND ANXIETY , SWEATING , TREMOR INCREASED THYROID HORMONE SECRETION DUE TO HYPERPLASIA OR NEOPLASIA OF THE GLAND EXOPHTHALMOS AUTO IMMUNE INVOLVEMENT Of RETROBULBARR CON. T. IN GRAVES DISEASE HYPERTENSION ADRENOCORTICAL HYPERPLASIA OR NEOPLASIA ADRENAL MEDULLARY NEOPLASM (PHEOCHROMOCYTOMA) EXCESSIVE GROWTH ( FEATURES VARY GROWTH HORMONE SECRETING PITUITARY ACCORDING TO WHETHER PRE OR POST- TUMOUR PUBERTAL ) GLUCOSURIA ABSOLUTE OR RELATIVE DEFICENCY OF INSULIN (DM) ENDOCRINE PATHOLOGY THE MAJOR DISORDER OF THE ENDOCRINE GKLANDS ARE :- Hyperfunction Hypofunction Benign & malignant tumours which themselves may case disordered function Many glands are independent , for example hypersecretion of a hormone by one gland may stimulate a target endocrine gland into overactivity Tumours or hyperfunction of one endocrine gland may be associated with similar disease in other glands in the multiple endocrine neoplasia (MEN) syndrome Organ specific autoimmune disease may affect more than one endocrine gland Pituitary Gland Diseases THE PITUITARY & ITS PHYSIOLOGICAL RELATIOSHIPS 9 The Pituitary Gland  Anterior pituitary Anterior pituitary: connected to the hypothalamus by hypothalmoanterior pituitary portal vessels. The anterior pituitary produces six peptide hormones: prolactin, growth hormone (GH), thyroid stimulating hormone (TSH), adrenocorticotropic hormone (ACTH), follicle-stimulating hormone (FSH), luteinizing hormone (LH).  Growth hormone (GH)  = ‘somatotropic hormone’ or ‘somatotropin’.  A small protein molecule, that contains 191- aa in a single chain.  Has great effect in growth & metabolism.  Acts on all cells of the body throughout life. Functions of growth hormone … B) Short- term metabolic effects: 1. Proteinmetabolism: Anabolic,  rate of protein synthesis in all cells. 2. Fat metabolism: Catabolic,  mobilization of FFAs from adipose tissue stores to provide energy. 3. CHO metabolism: Hyperglycemic,  rate of glucose utilization throughout the body, &  glucose uptake by cells. Thus, GH enhances body protein, uses up fat stores, & conserves carbohydrates The effects when a pituitary gland produces excess growth hormone (GH).  Acromegaly Acromegaly is a hormonal disorder that results when the pituitary gland produces excess growth hormone (GH). After closure of the epiphysis The name acromegaly comes from the Greek words for "extremities" and "enlargement“. It most commonly affects middle-aged adults (occurs in about 6 of every 100,000 adults). What Causes Acromegaly? caused by prolonged overproduction of GH by the pituitary gland. 1. Pituitary Tumors 2. Non-pituitary Tumors  Pituitary Tumors In over 90 percent of acromegaly patients, the overproduction of GH is caused by a benign tumor of the pituitary gland, (adenoma.) These tumors produce excess GH and, as they expand, compress surrounding brain tissues, such as the optic nerves. Non-pituitary Tumors In a few patients, acromegaly is caused not by pituitary tumors but by tumors of the pancreas, lungs, and adrenal glands. These tumors also lead to an excess of GH, either because they produce GH themselves or, more frequently, because they produce GHRH, the hormone that stimulates the pituitary to make GH. Symptoms Enlargement of the hands and feet Facial features become coarse as bones grow Body hair becomes coarse as the skin thickens and/or darkens Increased perspiration accompanied with body odor Protruding jaw Voice deepening Enlarged lip, nose, and tongue Degenerative arthritis Thickened ribs (creating a barrel chest) Joint pain Enlarged heart Symptoms cont. Enlargement of other organs Impotence in men Strange sensations and weakness in arms and legs Snoring Fatigue and weakness Headaches Loss of vision Irregular menstrual cycles in women Breast milk production in women Diagnosis Serial photos taken over the years To observe physical changes in the patient X-rays To detect bone thickening Blood tests To check the growth hormone level Typical Skull RX (Thickening of the Calvarium) of an Acromegalic patient THANK YOU