131224L - PITUITARY DISEASES

Lecture for 4^th year medical students on December 24, 2013 by Prof Omar Hasan Kasule Sr.

Anterior Pituitary disorders

·         Growth retardation / excess

·         Thyroid, adrenal, and gonadal dysfunction

Posterior pituitary disorders

·         Arginine deficiency

·         Oxytocin deficiency

·         vasopressin (ADH) deficiency: diabetes insipidus presenting as polydipsia and polyuria

Causes of pituitary disorders

·         Congenital hormone deficiency

·         Infection

·         Vascular Immunological

·         Neoplastic

·         Traumatic

·         Infiltration

·         Radiation damage

Acromegaly

·         Cause: pituitary tumor causing GH excess

·         Symptoms: change in appearance, increased size of hands and feet, headaches, excessive sweating, visual deterioration, tiredness, weight gain, amenorrhea, galacotrhhea, impotence/poor libido, deep voice, goiter, breathlessness, pain/tingling in the hands, polyuria/polydipsia, muscle weakness

·         Signs: prominent supra orbital ridge, prognathism, large toungue, spade-like feet and hands, thick greasy skin, visual field defects, galactorhea, hypertension, edema, heart failure, arthropathy, proximal myopathy, glycosuria

Galactorrhea

·         Galactorrhoea and secondary hypogonadism are signs of hyperprolactinaemia.

·         Patients with a prolactinoma can sometimes demonstrate bilateral galactorrhoea during the clinical examination.