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Disorders of pituitary gland
- 1. Pituitary glandSaddam AnsariTbilisiState Medical University
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- 3. Causes of Disorderof Pituitary Gland Mainly of 2 reasons:HyperactivityHypoactivity
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- 6. GigantismPituitary disorder characterizedby:Excess growth of bodyAverage height is approximately 7 – 8 feet
- 7. Continued…Causes of GigantismHypersecretionof GH in childhood or in pre – adult Tumor of acidophilic cells of Anterior pituitary
- 9. Continued…Signs and SymptomsHugestature : 7 or 8 feet heightHyperglycemia , develop glycosuria , pituitary diabetes mellitusHeadache due to tumor of pituitary
- 10. Continued…Visual disturbances Gigantismends in hypopituitarism (burning of cells of anterior pituitary )
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- 13. Acromegaly Anterior pituitarydisorder characterized by:Enlargement, thickening, and broadening of bonesParticularly extremities of the body
- 14. Continued…Causes of AcromegalyHypersecretionof GH after fusion of epiphysis with shaft of boneAdenomatous tumor of anterior pituitary involving the acidophilic cells.
- 16. Continued...Signs and symptomsStrikingfeatures are protrusion of :Supraorbital ridgesBroadening of nose Thickening of lipsThickening and wrinkles formation on foreheadLower jaw (prognathism)Face with these features called as acromegalic or guerilla face
- 17. Continued…Signs and symptomsKyphosis: enlargement of hands and feet with bowing spine Scalp is thickened and thrown into foldsOvergrowth of body hairVisceral organs are enlarged
- 19. Continued…Signs and symptomsThyroid, parathyroid and adrenal glands shows hyperactivityHyperglycemia and glucosuriaHypertensionHeadacheVisual disturbance – Bitemporal hemianopia
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- 24. Due to hypersecretionof GH in children,before fusion of epiphysis with the shaft of bone results in Gigantism
- 25. If hyersecretion ofGH is continued after the fusion of epiphysis the symptoms of Acromegaly also appear
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- 27. Cushing’s DiseaseRare diseasecharacterized by obesity
- 28. Continued…CauseHypersecretion of glucocorticoidsmainly cortisolEither pituitary origin or adrenal origin Cushing’s Cushing’s disease syndrome
- 29. Continued…Pituitary originIncreased secretionof ACTH leads to hyperplasia of adrenal cortex therefore, hypersecretion of glucocorticoids takes placeACTH is increased byTumor in pituitary cells ( basophilic cells)Malignant tumor of nonendocrine origin like cancer of lungs or abdominal visceraHypothalamic disorder causing hypersecretion of corticotropin releasing hormone
- 30. Continued…Signs and symptoms1.Disproportionate distribution of body fat results:Moon face : Fat accumulation and retention of water and salt Torso : Fat accumulation in chest and abdomen but slim legs and armsBuffalo hump : Fat deposit on the back of neck and shoulderPot belly : Fat accumulation in upper abdomen
- 32. Continued…2. Purple striae: Reddish purple stripes on abdomen due to mainly three reasons:Stretching of abdominal wall by excess subcutaneous fat
- 33. Rupture of subdermaltissues due to stretching
- 34. Deficiency of collagenfibres due to protein depletion
- 35. Continued…3. Thinning ofextremities4. Thinning of skin and subcutaneous tissues5. Darkening of skin on neck (aconthosis)6. Pigmentation of skin 7. Facial redness (facial plethora)8. Weakening of muscle
- 36. Continued…9. Facial hairgrowth ( Hirsutism )10. Bone resorption leads to osteoporosis11. Hyperglycemia due to gluconeogeneis leads adrenal diabetes and glycosuria12. Hypertension13. Immunosuppression resulting in susceptibility for infection14. Poor healing
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- 38. DwarfismPituitary disorder inchildren characterized by stunted growth
- 39. Cause of DwarfismReductionin the GH in infancy or early childhoodOccurs because of following reasons:Deficiency of GH releasing hormone from hypothalamus
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- 41. Atrophy of acidophiliccells in the adenohypophysis
- 42. Tumor of chromophobes : nonfunctioning tumor , compresses and destroys the normal cells
- 43. PanhypopituitarismSigns and SymptomsStuntedskeletal growth Maximum height approximately 3 feetHead becomes slightly larger in relation of bodyMental activity is normal without any deformityReproductive system is not affected due to lack of GH but in Panhypopituitarism puberty is not obtained due to lack of gonadotropic hormone
- 44. Types of DwarfismLarondwarfismPsychogenic dwarfismDwarfism in dystrophiaadiposogenitalis
- 45. Laron DwarfismGenetical disorderCalledas GH insensitivityOccurs due to presence of abnormal GH secretagogue receptors in liverGHS becomes abnormal due to mutation in genes responsible for receptorDoesn’t depend on amount of GH secretion , hormone can’t stimulate the growth due to abnormal GHS
- 46. Psychogenic DwarfismDue toextreme emotional deprivation or stressDeficiency of GHAlso called as psychosocial dwarfism or Stress dwarfism
- 47. Dwarfism in DystrophiaadiposogenitalisCalledas Frohlich syndromeRare childhood disorderCharacterized by :Obesity
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- 49. Retarded development ofgenital organs
- 50. Associated with tumorsof hypothalamus – increased appetite and decrease in gonadotropin hormoneDisorders of Pituitary Gland
- 51. AcromicriaRare disease inadults characterized by the atrophy of the extremities of the body
- 52. Causes of AcromicriaDeficiencyof GH in adultsSecretion of GH decreases in the following conditions:Deficiency of GH releasing hormone
- 53. Atrophy of acidophiliccells in the anterior pituitary
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- 56. Signs and SymptomsAtrophyand thinning of extremities ( major symptoms )Associated with hypothyroidismHyposecretion of adrenocortical hormonePerson becomes lethargic and obeseLoss of sexual function
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- 58. Simmond’s DiseaseRare pituitarydiseaseAlso called as cachexiaOccurs mostly in panhypopituitarism
- 59. Signs and SymptomsDevelopingsenile decay Senile decay is due to deficiency of hormone from target glands of anterior pituitary e.g. thyroid gland, adrenal cortex and the gonadsLoss of hair and loss of teethThe skin on face becomes dry and wrinkled. ( most common )
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- 63. Syndrome of InappropriateHypersecretion of Antidiuretic hormone Disease characterized by loss of sodium through urine due to hypersecretion of ADH
- 64. CausesDue to cerebraltumors, lung tumors and lung cancers because the tumor cells secrete ADHNormal secretion of ADH makes the plasma hypotonicHypotonic solution inhibits the ADH secretion and restoration of plasma osmolarity takes placeBut in SIADH ,secretion of ADH from tumor is not inhibited by hypotonic plasma
- 65. Signs and SymptomsLossof appetiteWeight lossNausea and vomitingHeadacheMuscle weakness , spasm and crampsFatigueRestlessness and irritabilityIn severe conditions patient die because of coma and convulsions
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- 67. Diabetes InsipidusPosterior Pituitarydisorder characterized by excess excretion of water through urine
- 68. Causes Develops dueto the deficiency of ADH which occurs in the following conditions:Lesion (injury) or degradation of supraoptic and paraventricular nuclei of hypothalamusLesion in hypothalamo-hypophyseal tractAtrophy of posterior pituitaryInability of renal tubules to give response to ADH hormone. Called as Nephrogenic diabetic insipidus.
- 69. Signs and Symptoms1.PolyuriaExcretion of large quantity of dilute urine with increased frequency of voiding is called polyuriaDaily output is 4 to 12 liters.Due to absence of ADH ,the epithelial cells of distal convoluted tubule in the nephron and the collecting duct of the kidney becomes impermeable to water
- 70. Continued…2.PolydipsiaIntake of excesswaterBecause of polyuria ,thirst center in hypothalamus results in intake of large quantity of water
- 71. Continued…3.Dehydration In somecases ,the thirst center in the hypothalamus is also affected by the lesionTherefore water intake decreases in these patients and, the loss of water through urine is not compensated
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- 73. DystrophiaAdiposogenitalisCharacterized by obesityand hypogonadism affecting mainly adolescent boysAlso known as Frohlich syndrome or hypothalamic eunuchism
- 74. Causes Hypoactivity ofboth anterior and posterior pituitaryTumor in pituitary gland and hypothalamic regions concerned with food intake and gonadal developmentInjury or atrophy of pituitary gland Genetic inablility of hypothalamus to secrete luteinizing hormone
- 75. Symptoms Obesity (commonfeature)Sexual infantilism (failure to develop secondary sexual characters)Dwarfism occurs if disease starts in growing ageCalled as infantile or prepubertal type of Frohlich syndrome (in children) and adult type of Frohlich’s syndrome (in adults)Other features are loss of vision and diabetes