ⓘ Hyperpituitarism is a condition due to the primary hypersecretion of pituitary hormones; it typically results from a pituitary adenoma. In children with hyperpi ..

                                     

ⓘ Hyperpituitarism

Hyperpituitarism is a condition due to the primary hypersecretion of pituitary hormones; it typically results from a pituitary adenoma. In children with hyperpituitarism, disruption of growth regulation is rare, either because of hormone hypersecretion or because of manifestations caused by local compression of the adenoma.

                                     

1. Cause

The cause of hyperpituitarism in most cases is due to pituitary adenomas. They usually come from the anterior lobe, are functional and secrete the hormone, GH and prolactin.

                                     

2. Mechanism

Evidence indicates that the mechanism of hyperpituitarism can originate from genetic disruption causing pituitary tumorigenesis, most pituitary adenomas are monoclonal, which in turn indicates their origin from an event in a single cell. There are three hormones that are oversecreted resulting in the pituitary adenoma: prolactin, adrenocorticotropic hormone ACTH, and growth hormone GH.

Excess prolactin may result in a prolactinoma Excess GH results in gigantism, the severity of gigantism depends on whether the epiphyseal plate is open. The four most common types of hyperpituitarism are prolactinoma, corticotropinoma Cushings disease, somatotropinoma gigantism, and thyrotropinoma.

                                     

3. Diagnosis

For the diagnosis of hyperpituitarism it depends on the cell types affected, clinical manifestations of hormone excess may include, gigantism or acromegaly, which can be identified by clinical and radiographic results. Cushings disease diagnosis is done with a physical examination, laboratory tests and X rays of the pituitary glands to locate tumors For prolactinoma, diagnosis comes in the form of the measurement of serum prolactin levels and x-ray of pituitary gland.

                                     

4. Treatment

Treatment for hyperpituitarism in the case of prolactinoma consists of long-term medical management. Dopamine agonists are strong suppressors of PRL secretion and establish normal gonadal function. It also inhibits tumor cell replication in some cases causes tumor shrinkage Treatment for gigantism begins with establishing target goals for IGF-1, transsphenoidal surgery somatostatin receptor ligands- preoperatively and postoperative imaging assessment. For Cushings disease there is surgery to extract the tumor; after surgery, the gland may slowly start to work again, though not always.

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