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British Medical Journal Nov 1970
Topics: Acromegaly; Adrenocorticotropic Hormone; Chlorpropamide; Diabetes Insipidus; Humans; Hypothyroidism; Pituitary Diseases; Thyrotropin
PubMed: 4320424
DOI: No ID Found -
The Journal of Neuropsychiatry and... 2005Increasingly, patients with pituitary disease are evaluated and treated at cancer centers. In many ways, these patients resemble patients with other malignant brain... (Review)
Review
Increasingly, patients with pituitary disease are evaluated and treated at cancer centers. In many ways, these patients resemble patients with other malignant brain tumors. Although the majority of pituitary adenomas are benign, the physical, emotional, and cognitive changes that these patients experience on their well-being is malignant. Pituitary disease causes a variety of physical illnesses resulting from the alterations in the hypothalamic-pituitary-end organ axis. In addition, patients with pituitary diseases may experience many emotional problems, including depression, anxiety, behavioral disturbances, and personality changes, above and beyond the many reactions these patients may have to the myriad of adjustments that they must make in their lives. There is a growing understanding that pituitary patients may experience these emotional problems as a result of long-term effects that the pituitary tumor itself, treatment, and/or hormonal changes have on the hypothalamic-pituitary-end organ axis. The authors present a series of cases, in which patients with pituitary disease were diagnosed and treated for depression and showed little response to the treatment for depression. When the diagnosis of apathy syndrome was considered and treatment implemented, the patients' condition improved. A review of the literature on apathy, hypothalamic-pituitary-end organ axis dysfunction, and treatment for apathy syndrome is included.
Topics: Adenoma; Adult; Affect; Depression; Humans; Male; Middle Aged; Pituitary Diseases; Pituitary Neoplasms; Prolactinoma
PubMed: 15939968
DOI: 10.1176/jnp.17.2.159 -
Minerva Ginecologica Apr 2017The pituitary gland plays a critical role in reproduction. In response to the hypothalamus the anterior pituitary secretes prolactin, thyroid-stimulating hormone,... (Review)
Review
A primer on pituitary injury for the obstetrician gynecologist: Simmond's disease, Sheehan's Syndrome, traumatic injury, Dahan's Syndrome, pituitary apoplexy and lymphocytic hypophysitis.
The pituitary gland plays a critical role in reproduction. In response to the hypothalamus the anterior pituitary secretes prolactin, thyroid-stimulating hormone, adreno-corticotropic hormone, follicle-stimulating hormone, luteinizing hormone and growth hormone. Dysregulation in these hormones often lead to reproductive failure. Multiple mechanisms of pituitary injury exist. Simmond's disease is atrophy or destruction of the anterior lobe of the pituitary gland resulting in hypopituitarism. Sheehan's syndrome is post-partum pituitary injury due to massive hemorrhage. Traumatic injury resulting in hemorrhage in a non-pregnancy state can also cause partial or complete pituitary failure. Dahan's syndrome is pituitary injury due to severe vasospasm, without significant hemorrhage. Pituitary apoplexy is infarction of a pituitary adenoma and intra-mass hemorrhage with result injury to hormone production by the gland. Lymphocytic infiltration is the most common cause of hypophysitis and the mechanism is often unknown, although it may be autoimmune-related. The mechanism and treatments of each of these pathologies will be discussed in a context of reproduction.
Topics: Autoimmune Hypophysitis; Humans; Hypopituitarism; Pituitary Apoplexy; Pituitary Diseases; Pituitary Gland; Reproduction
PubMed: 27405776
DOI: 10.23736/S0026-4784.16.03956-3 -
Clinics in Endocrinology and Metabolism Nov 1983Morphological features of pituitary disease are classified according to increased and decreased hormone production to allow clinical correlation with pathological... (Review)
Review
Morphological features of pituitary disease are classified according to increased and decreased hormone production to allow clinical correlation with pathological processes. Increased hormone synthesis and secretion may be due to pituitary adenomas or carcinomas derived from the five hormone-secreting cell types, or to extrapituitary stimuli causing hypertrophy and hyperplasia of those cells. Various tumour-like conditions can mimic functioning adenomas. Rarely, no lesion is detected and intrinsic abnormalities of adenohypophyseal cells are implicated. Hypopituitarism can be selective or generalized. Diffuse hormone deficiency is usually attributable to tissue destruction by tumours, inflammatory or infiltrative conditions or vascular lesions. Congenital abnormalities of pituitary development may result in hypophyseal dysfunction. Hypothalamic abnormalities may cause generalized hypopituitarism or may involve only selective releasing factors and hormones. Feedback inhibition and receptor abnormalities may be implicated in pituitary hypofunction, and selective deficiencies may be the result of genetic abnormalities, immune reactions or toxic damage to one cell type.
Topics: Adenoma; Adrenocorticotropic Hormone; Growth Hormone; Humans; Hypertrophy; Hypothalamus; Neoplasm Metastasis; Pituitary Diseases; Pituitary Gland; Pituitary Hormones; Pituitary Neoplasms; Prolactin
PubMed: 6323064
DOI: 10.1016/s0300-595x(83)80056-5 -
Psychotherapy and Psychosomatics 1998It has been recognized for some time that psychiatric symptoms, such as depression, anxiety, and behavioral alterations, may occur in patients who have pituitary... (Review)
Review
It has been recognized for some time that psychiatric symptoms, such as depression, anxiety, and behavioral alterations, may occur in patients who have pituitary disease. From other research focused on endocrine abnormalities seen in patients with psychiatric illness, it is understood that there is a significant interrelationship between the endocrine system and mental health. More recent research focusing on neural circuits in the brain and the impact of alterations in neurotransmission and neurohormonal modulation has shown that the prefrontal cortex can be affected by perturbations in functioning occurring in distant sites. Such is the situation with the hypothalamic-pituitary axis. Through its rich connections with other limbic structures, the hypothalamic-pituitary axis may affect the behavioral control exerted by the prefrontal cortex, causing mood and personality alterations. In the more severe cases, an apathy syndrome may develop which must be carefully differentiated from depression and other cognitive disorders. This report will review: (1) the neuroanatomical components that cause the behavioral changes observed in many patients with pituitary disease; (2) the current concept of apathy syndrome; (3) the differentiation of apathy syndrome from major depression; (4) the underlying neurobiology of apathy, and (5) potential treatments.
Topics: Depressive Disorder; Diagnosis, Differential; Humans; Motivation; Pituitary Diseases; Syndrome
PubMed: 9667059
DOI: 10.1159/000012272 -
The Journal of Clinical Endocrinology... Feb 2008The pituitary gland secretes vital trophic hormones that maintain homeostatic regulation of the metabolic milieu. Not surprisingly, several thousand papers relevant to... (Review)
Review
The pituitary gland secretes vital trophic hormones that maintain homeostatic regulation of the metabolic milieu. Not surprisingly, several thousand papers relevant to the pituitary gland were published this past year, including publication of important transforming advances in our understanding of the pathogenesis, diagnosis, and treatment of pituitary disorders. In an attempt to focus on outstanding key articles reporting highlights of the year, quality inclusion criteria were applied. High-quality articles were selected for their translational impact, scientific advances, enrichment of new knowledge, influence on how we understand pituitary disorders, transformation of therapeutic principles, and opening up new research vistas. Using these selection criteria, highlighted papers within the following categorical topics were further selected for analysis and review: advances in understanding subcellular mechanisms subserving the pathogenesis of pituitary disorders including pituitary tumors and pituitary failure; new challenges facing the physician treating patients harboring prolactinomas with dopamine agonists; and the appearance of new publications reporting the efficacy of long-term prospective medical treatment of acromegaly that now provide more rigorous patient outcome information. Selected papers categorized by these topics all serve to significantly impact how the endocrinologist views disease pathogenesis, diagnosis, and treatment outcomes of patients with pituitary disease in 2007. The results of these publications have transformed our understanding of important principles underlying normal and abnormal pituitary function, as well as our approach to the management of pituitary disorders. Notably, they open up new vistas for creative scholarship in unraveling the challenges of pituitary medicine.
Topics: Acromegaly; Female; Human Growth Hormone; Humans; Male; Pituitary Diseases; Pituitary Neoplasms; Prolactinoma
PubMed: 18258780
DOI: 10.1210/jc.2007-1409 -
Endocrine Reviews Aug 2018Neuroendocrinology of bone is a new area of research based on the evidence that pituitary hormones may directly modulate bone remodeling and metabolism. Skeletal... (Review)
Review
Neuroendocrinology of bone is a new area of research based on the evidence that pituitary hormones may directly modulate bone remodeling and metabolism. Skeletal fragility associated with high risk of fractures is a common complication of several pituitary diseases such as hypopituitarism, Cushing disease, acromegaly, and hyperprolactinemia. As in other forms of secondary osteoporosis, pituitary diseases generally affect bone quality more than bone quantity, and fractures may occur even in the presence of normal or low-normal bone mineral density as measured by dual-energy X-ray absorptiometry, making difficult the prediction of fractures in these clinical settings. Treatment of pituitary hormone excess and deficiency generally improves skeletal health, although some patients remain at high risk of fractures, and treatment with bone-active drugs may become mandatory. The aim of this review is to discuss the physiological, pathophysiological, and clinical insights of bone involvement in pituitary diseases.
Topics: Animals; Fractures, Bone; Humans; Osteoporosis; Pituitary Diseases
PubMed: 29684108
DOI: 10.1210/er.2018-00005 -
Archives of Medical Research Nov 2013Hormonal derangements at the level of the hypothalamic-pituitary axis are often seen with the worsening of kidney function. This may not be surprising given the role of... (Review)
Review
Hormonal derangements at the level of the hypothalamic-pituitary axis are often seen with the worsening of kidney function. This may not be surprising given the role of the kidney in synthesis, metabolism and elimination of many of these hormones. Traditionally, these derangements have been understood as a consequence of kidney failure. Conversely, recent evidence points towards the implication of such hormonal disorders in the genesis of CKD. In this review we present arguments supporting both the role of hypothalamic-pituitary axis dysfunction as a consequence of uremic complications and a culprit in disease incidence and progression. Focus is given to evidence regarding thyroidal, adrenal and gonadal axes.
Topics: Adrenal Cortex Hormones; Adrenal Gland Diseases; Disease Progression; Gonadal Steroid Hormones; Humans; Hypothalamic Diseases; Incidence; Pituitary Diseases; Renal Insufficiency, Chronic; Thyroid Hormones
PubMed: 24215784
DOI: 10.1016/j.arcmed.2013.10.009 -
Clinical Medicine (London, England) Mar 2023Pituitary incidentalomas are common findings with increasing use of modern neuroradiological imaging undertaken for symptoms unrelated to pituitary disease. The...
Pituitary incidentalomas are common findings with increasing use of modern neuroradiological imaging undertaken for symptoms unrelated to pituitary disease. The prevalence of these lesions is ∼10% in autopsy studies and the incidence varies from 10% to 38% on magnetic resonance imaging in the published literature. They are almost always benign in nature and most are non-functioning (non-secreting) adenomas. Although many individuals are asymptomatic at diagnosis, some with functioning (secreting) pituitary adenomas or larger non-functioning adenomas have symptoms. All identified cases should have a thorough clinical and endocrinological evaluation to help with precise management, which depends on the size of the lesion, hormonal status (functioning versus non-functioning adenoma) and the presence of visual deficits resulting from optic nerve compression by the pituitary adenoma. Here, we provide an overview of the initial assessment and management of pituitary incidentalomas for clinicians not routinely involved in the management of pituitary disease.
Topics: Humans; Incidental Findings; Pituitary Neoplasms; Pituitary Diseases; Adenoma; Magnetic Resonance Imaging
PubMed: 36958836
DOI: 10.7861/clinmed.2023-0020 -
Annales D'endocrinologie Apr 2012Outcome data from large series confirm increased mortality of patients with pituitary tumours, predominantly due to vascular disease. Control of cortisol secretion and...
Outcome data from large series confirm increased mortality of patients with pituitary tumours, predominantly due to vascular disease. Control of cortisol secretion and growth hormone (GH) hypersecretion (together with cardiovascular risk factor reduction) is key in the normalisation of mortality rates in patients with Cushing's disease and acromegaly, respectively, though some excess mortality may persist even in "cured" patients.
Topics: Cause of Death; Comorbidity; Humans; Mortality; Pituitary ACTH Hypersecretion; Pituitary Diseases; Vascular Diseases
PubMed: 22503666
DOI: 10.1016/j.ando.2012.03.026