Pituitary disorders

S. Mekned and R. J. Robbias, eds.. Molecular and ClinicalMdvances in Pituitary Disorders, Blackwell Scientific Publications, St. Louis, Mo., 1991. 

Other Inflammatory Muscle Disorders Endocrine Myopathies Thyroid Disorders Adrenal Disorders Pituitary Disorders Parathyroid Disorders Pancreatic Disorders Drug-Induced and Toxic Myopathies Management of Muscle Disease... 

The patient likely will have a history of childhood-onset GH deficiency, hypothalamic or pituitary disorder, or the presence of three or four other pituitary hormone deficiencies caused by head trauma, tumor, infiltrative diseases, surgery, or radiation therapy. 

Causes of organic ED include diseases that compromise vascular flow to the corpora cavernosum (e.g., peripheral vascular disease, arteriosclerosis, essential hypertension), impair nerve conduction to the brain (e.g., spinal cord injury, stroke), and are associated with hypogonadism (e.g., prostate or testicular cancer, hypothalamic or pituitary disorders). 

The penis has two corpora cavernosa, which have many interconnected sinuses that fiU with blood to produce an erection. The penis also has one corpus spongiosum, which surrounds the urethra and forms the glans penis. Acetylcholine works with other neurotransmitters (i.e., cyclic guanylate monophosphate, cyclic adenosine monophosphate, vasoactive intestinal polypeptide) to produce penile arterial vasodilation and ultimately an erection. Causes of organic ED include diseases that compromise vascular flow to the corpora cavernosum (e.g., peripheral vascular disease, arteriosclerosis, essential hypertension), impair nerve conduction to the brain (e.g., spinal cord injury, stroke), and are associated with hypogonadism (e.g., prostate or testicular cancer, hypothalamic or pituitary disorders). 

Interpretation LH response should increase by threefold to tenfold. The FSH response is of lesser magnitude (usually a 1.5- to 3-fold increase). The peak responses for both LH and FSH occur between 15 and 30 minutes. Patients with pituitary disorders may have normal, dunmished, or absent responses. 

Late-onset adrenal hyperplasia Cushing s syndrome Virilizing adrenal tumors Adrenocorticoid insufficiency Thyroid disorders Hypothyroidism Hyperthyroidism Pituitary disorders... 

The investigation of any pituitary disorder usually includes a CAPFT which comprises the simultaneous administration of insulin (stimulates ACTH. GH and prolactin). TRH (stimulates TSH and prolactin) and GnRH (stimulates FSH and LH). This complex test is discussed in detail on pages 76-77. 

Buckstrom, M., Hall, K. and Sara, V. (1984) Somatomedin levels in cerebrospinal fluid from adults with pituitary disorders. Acta Endocrinol. (Copenhagen) 107 171-178. 

Usually, ACTH deficienoy in humans is associated with a pituitary disorder rather than with a deficiency of CRF, and oCRF can be used to distinguish between pituitary hypersecretion of ACTH (Cushing s disease) and ectopic ACTH secretion, both of which are conditions that cause a hypersecretion of hydrocortisone. In the case of ectopic ACTH secretion, the administration of oCRF will elicit little to no response in the production of ACTH and hydrocortisone. Therefore, synthetic oCRF trifluoroacetate salt is marketed as a diagnostic agent for patients with ACTH-dependent Cushing s syndrome. 

Some of the drugs used for pituitary disorders include desmopressin acetate (DDAV), desmopressin (Stimate), lypressin (Diapid), vasopressin (aqueous) (Pitressin), vasopressin tannate/oil (Pitressin Tannate). 

Otsuki, M., Tateiwa, M., and Baba, S., TRF test in patients with hypothalamic-pituitary disorders. Endocrinol. Jap. 20, 149-155 (1973). 

Human insuhn will become widely available for treating diabetes. Human growth hormone will be used for treating pituitary disorders. Recombivax Hb, a vaccine for hepatitis B, will be marketed. 

This presents in children as delayed puberty or in adults as infertility. It can be a primary condition due to gonadal dysfunction or secondary to hypothalamic or pituitary disorders. 

Also, there are various other causes of hair loss such as disorders of the scalp, reaction to certain drugs or chemicals, venereal disease, and infection. Loss of hair also occurs in thyroid deficiency (myxedema) and in certain types of pituitary disorders. 

---