Pituitary disorders tumors

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. 

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

Plasma cell disorders Plasma cell disorders Inflammation-associated, familial Mediterranean fever Familial amyloidotic neuropathy, systemic senile amyloidosis Dialysis-associated amyloidosis Familial amyloidotic neuropathy, aortic amyloidosis Familial systemic amyloidosis Familial systemic amyloidosis Familial systemic amyloidosis Familial cerebral hemorrhage with amyloidosis Sporadic and familial Alzheimer s disease, familial cerebral hemorrhage with amyloidosis Spongiform encephalopathies C-cell thyroid tumors Insulinoma, type II diabetes Atrial amyloidosis Prolactinomas pituitary amyloidosis Iatrogenic amyloidosis Corneal amyloidosis ... 

Bromocriptine (Parl el) [Antiparkinsonian Agent/Dopamine Receptor Agonist] Uses Parkin on Dz, hyperprolactinemia, acromegaly, pituitary tumors Action Direct-acting on the striatal dopamine receptors X prolactin secretion Dose Initial, 1.25 mg PO bid titrate to effect, w/ food Caution [B, ] Contra Severe ischemic heart Dz or PVD Disp Tabs, caps SE X BP, Raynaud phenomenon (vasospastic disorder resulting in discoloration of the fmgers/toes), dizziness, N, hallucinations Interactions T Effects W/ erythromycin, fluvoxamine, nefazodone, sympathomimetics, antihypertensives X effects W/ phenothiazines, antipsychotics EMS Monitor BP may cause intolerance to EtOH OD May cause NA, severe hypotension give IV fluids symptomatic and supportive... 

Tertiary hypothyroidism, or hypothalamic hypothyroidism, results from impaired TRH stimulation of pituitary TSH. This may be due to a disorder that damages the hypothalamus or interferes with hypothalamic-pituitary portal blood flow, thereby preventing delivery of TRH to the pituitary. Tumors, trauma, radiation therapy, or infiltrative disease of the hypothalamus can cause such damage. This relatively rare form of hypothyroidism is also characterized by inappropriately low levels of serum TSH. 

The assessment of anterior and posterior pituitary lobe function in patients with pituitary tumors is important in the identification of clinically significant hormone deficiency states caused by the tumor itself and for the reevaluation of patients after pituitary surgery or irradiation to detect hormone deficiencies that occur as a result of invasive treatment. Testing of pituitary function is usually performed under basal conditions but can be performed under provocative conditions to bring out subtle or mild deficiencies that are observed with disorders of the adrenal gland, thyroid, or gonads. Evaluation of pituitary reserve for GH or PRL is usually unnecessary in adult patients because deficiencies of these hormones are not believed to be clinically important. 

Hyperprolactinemia is a common disorder that can have a significant impact on fertility. Hyperprolactinemia is most commonly caused by the presence of prolactin-secreting pituitary tumors and various medications that antagonize dopamine or increase the secretion of prolactin. Available treatment options for this disorder include medical therapy with dopamine agonists, radiation therapy, and transsphenoidal surgery. In most cases, medical therapy with dopamine agonists... 

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