Disorders of pituitary gland
- 1. Pituitary glandSaddam AnsariTbilisi State Medical University
- 2. Disorders of Pituitary Gland
- 3. Causes of Disorder of Pituitary Gland Mainly of 2 reasons:HyperactivityHypoactivity
- 4. Disorders of Pituitary Gland
- 5. Disorders of Pituitary Gland
- 6. GigantismPituitary disorder characterized by:Excess growth of bodyAverage height is approximately 7 – 8 feet
- 7. Continued…Causes of GigantismHypersecretion of GH in childhood or in pre – adult Tumor of acidophilic cells of Anterior pituitary
- 9. Continued…Signs and SymptomsHuge stature : 7 or 8 feet heightHyperglycemia , develop glycosuria , pituitary diabetes mellitusHeadache due to tumor of pituitary
- 10. Continued…Visual disturbances Gigantism ends in hypopituitarism (burning of cells of anterior pituitary )
- 12. Disorders of Pituitary Gland
- 13. Acromegaly Anterior pituitary disorder characterized by:Enlargement, thickening, and broadening of bonesParticularly extremities of the body
- 14. Continued…Causes of AcromegalyHypersecretion of GH after fusion of epiphysis with shaft of boneAdenomatous tumor of anterior pituitary involving the acidophilic cells.
- 16. Continued...Signs and symptomsStriking features 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
- 22. Disorders of Pituitary Gland
- 24. Due to hypersecretion of GH in children,before fusion of epiphysis with the shaft of bone results in Gigantism
- 25. If hyersecretion of GH is continued after the fusion of epiphysis the symptoms of Acromegaly also appear
- 26. Disorders of Pituitary Gland
- 27. Cushing’s DiseaseRare disease characterized by obesity
- 28. Continued…CauseHypersecretion of glucocorticoids mainly cortisolEither pituitary origin or adrenal origin Cushing’s Cushing’s disease syndrome
- 29. Continued…Pituitary originIncreased secretion of 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 subdermal tissues due to stretching
- 34. Deficiency of collagen fibres due to protein depletion
- 35. Continued…3. Thinning of extremities4. 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 hair growth ( 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
- 37. Disorders of Pituitary Gland
- 38. DwarfismPituitary disorder in children characterized by stunted growth
- 39. Cause of DwarfismReduction in the GH in infancy or early childhoodOccurs because of following reasons:Deficiency of GH releasing hormone from hypothalamus
- 40. Deficiency of Somatomedin – C
- 41. Atrophy of acidophilic cells in the adenohypophysis
- 42. Tumor of chromophobes : nonfunctioning tumor , compresses and destroys the normal cells
- 43. PanhypopituitarismSigns and SymptomsStunted skeletal 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 DwarfismLaron dwarfismPsychogenic dwarfismDwarfism in dystrophiaadiposogenitalis
- 45. Laron DwarfismGenetical disorderCalled as 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 to extreme emotional deprivation or stressDeficiency of GHAlso called as psychosocial dwarfism or Stress dwarfism
- 47. Dwarfism in DystrophiaadiposogenitalisCalled as Frohlich syndromeRare childhood disorderCharacterized by :Obesity
- 49. Retarded development of genital organs
- 50. Associated with tumors of hypothalamus – increased appetite and decrease in gonadotropin hormoneDisorders of Pituitary Gland
- 51. AcromicriaRare disease in adults characterized by the atrophy of the extremities of the body
- 52. Causes of AcromicriaDeficiency of GH in adultsSecretion of GH decreases in the following conditions:Deficiency of GH releasing hormone
- 53. Atrophy of acidophilic cells in the anterior pituitary
- 56. Signs and SymptomsAtrophy and thinning of extremities ( major symptoms )Associated with hypothyroidismHyposecretion of adrenocortical hormonePerson becomes lethargic and obeseLoss of sexual function
- 57. Disorders of Pituitary Gland
- 58. Simmond’s DiseaseRare pituitary diseaseAlso called as cachexiaOccurs mostly in panhypopituitarism
- 59. Signs and SymptomsDeveloping senile 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 )
- 60. Summary…..
- 62. Disorders of Pituitary Gland
- 63. Syndrome of Inappropriate Hypersecretion of Antidiuretic hormone Disease characterized by loss of sodium through urine due to hypersecretion of ADH
- 64. CausesDue to cerebral tumors, 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 SymptomsLoss of appetiteWeight lossNausea and vomitingHeadacheMuscle weakness , spasm and crampsFatigueRestlessness and irritabilityIn severe conditions patient die because of coma and convulsions
- 66. Disorders of Pituitary Gland
- 67. Diabetes InsipidusPosterior Pituitary disorder characterized by excess excretion of water through urine
- 68. Causes Develops due to 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.Polyuria Excretion 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 excess waterBecause of polyuria ,thirst center in hypothalamus results in intake of large quantity of water
- 71. Continued…3.Dehydration In some cases ,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
- 72. Disorders of Pituitary Gland
- 73. DystrophiaAdiposogenitalisCharacterized by obesity and hypogonadism affecting mainly adolescent boysAlso known as Frohlich syndrome or hypothalamic eunuchism
- 74. Causes Hypoactivity of both 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 (common feature)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