Disorder of Pituitary Glands .
[1]. Disorder of the Pituitary Glands refers to the abnormality in structure & Physiology of the Pituitary Glands .
[2]. It is describes as the malfunctioning of Pituitary Glands secretion who leads to Hyposecretion of hormone or Hypersecretion of hormone .
[3]. Disorder of the pituitary Glands also occurs due to degeneration of cells , tissue related to secretion . Hyposecretion of Pituitary Hormone leads to the disorder or disease of pituitary glands , others organs of the body and altering the functioning of the specific organs or parts of the body .
[4]. Hypersecretion of Pituitary hormone also leads to disorders / disease of the pituitary glands , other systemic physiology alternation and affects the body parts leads abnormal structural deformities or outgrowth appearance visible by naked eye .
[5]. Pituitary Glands is known as master Glands of Hormonal Secretion Which having control system over Glands of the body which enhances secretion of hormone or inhibition of hormone .
Hyperactivity of Anterior Pituitary Glands .
1. Gigantism .
[1]. Gigantism is the pituitary disorder characterized by excess growth of the body.
[2]. The subjects look like the giants with average height of about 7 to 8 feet.
Causes of Gigantism .
[1]. Gigantism is due to hypersecretion of GH in childhood or in pre-adult life before the fusion of epiphysis of bone with shaft.
[2]. Hypersecretion of GH is because of tumor of acidophil cells in the anterior pituitary.
Signs and symptoms of Gigantism .
[1]. General overgrowth of the person leads to the development of a huge stature, with a height of more than 7 or 8 feet. The limbs are disproportionately long
[2]. Giants are hyperglycemic and they develop glycosuria and pituitary diabetes. Hyperglycemia causes constant stimulation of β-cells of islets of Langerhans in the pancreas and release of insulin. However, the overactivity of β-cells of Langerhans in pancreas leads to degeneration of these cells and deficiency of insulin and ultimately, diabetes mellitus is developed
[3]. Tumor of the pituitary gland itself causes constant headache .
[4]. Pituitary tumor also causes visual disturbances. It compresses the lateral fibers of optic chiasma, leading to bitemporal hemianopia .
2. Acromegaly .
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| Acromegaly . |
Acromegaly is the disorder characterized by the enlargement, thickening and broadening of bones, particularly in the extremities of the body.
Causes of Acromegaly .
[1]. Acromegaly is due to hypersecretion of GH in adults after the fusion of epiphysis with shaft of the bone.
[2]. Hypersecretion of GH is because of tumor of acidophil cells in the anterior pituitary.
Signs and symptoms of Acromegaly .
[1]. Acromegalic or gorilla face: Face with rough features such as protrusion of supraorbital ridges, broadening of nose, thickening of lips, thickening and wrinkles formation on forehead and prognathism (protrusion of lower jaw)
[2]. Enlargement of hands and feet
[3]. Kyphosis (extreme curvature of upper back – thoracic spine)
[4]. Thickening of scalp. Scalp is also thrown into folds or wrinkles like bulldog scalp
[5]. Overgrowth of body hair
[6]. Enlargement of visceral organs such as lungs, thymus, heart, liver and spleen
[7]. Hyperactivity of thyroid, parathyroid and adrenal glands
[8]. Hyperglycemia and glucosuria, resulting in diabetes mellitus
[9]. Hypertension
[10]. Headache
[11]. Visual disturbance (bitemporal hemianopia).
3. Acromegalic Gigantism .
[1]. Acromegalic gigantism is a rare disorder with symptoms of both gigantism and acromegaly.
[2]. Hypersecretion of GH in children, before the fusion of epiphysis with shaft of the bones causes
Gigantism and if hypersecretion of GH is continued even after the fusion of epiphysis, the symptoms of acromegaly also appear.
4. Cushing Disease .
[1]. It is also a rare disease characterized by obesity. Causes Cushing disease develops by basophilic adenoma of adenohypophysis.
[2]. It increases the secretion of adrenocorticotropic hormone, which in turn stimulates the adrenal cortex to release cortisol.
[3]. Cushing disease also develops by hyperplasia or tumor of adrenal cortex.
[4]. Usually, the disorder due to the pituitary cause is called Cushing disease and when it is due to the adrenal cause, it is called Cushing syndrome.
Hypoactivity of anterior Pituitary .
1. Dwarfism .
Dwarfism is a pituitary disorder in children, characterized by the stunted growth.
Causes of Dwarfism .
Reduction in GH secretion in infancy or early childhood causes dwarfism. It occurs because of the following reasons:
[1]. Tumor of chromophobes: It is a non-functioning tumor, which compresses and destroys the normal cells secreting GH. It is the most common cause for hyposecretion of GH, leading to dwarfism
[2]. Deficiency of GH-releasing hormone secreted by hypothalamus
[3]. Deficiency of somatomedin C
[4]. Atrophy or degeneration of acidophilic cells in the anterior pituitary
[5]. Pan hypopituitarism: In this condition, there is reduction in the secretion of all the hormones of anterior pituitary gland. This type of dwarfism is associated with other symptoms due to the deficiency of other anterior pituitary hormones.
Signs and symptoms of Dwarfism .
[1]. Primary symptom of hypopituitarism in children is the stunted skeletal growth. The maximum height of anterior pituitary dwarf at the adult age is only about 3 feet
[2]. But the proportions of different parts of the body are almost normal. Only the head becomes slightly larger in relation to the body
[3]. Pituitary dwarfs do not show any deformity and their mental activity is normal with no mental retardation
[4]. Reproductive function is not affected, if there is only GH deficiency. However, during pan hypopituitarism, the dwarfs do not obtain puberty due to the deficiency of gonadotropic hormones.
Laron dwarfism .
[1]. Laron dwarfism is a genetic disorder. It is also called GH insensitivity.
[2]. It occurs due to the presence of abnormal growth hormone secretagogue (GHS) receptors in liver. [3]. GHS receptors become abnormal because of the mutation of genes for the receptors.
[4]. GH secretion is normal or high. But the hormone cannot stimulate growth because of the abnormal GHS receptors. So, dwarfism occurs.
Psychogenic dwarfism .
[1]. Dwarfism occurs if the child is exposed to extreme emotional deprivation or stress.
[2]. The short stature is because of deficiency of GH.
[3]. This type of dwarfism is called psychogenic dwarfism, psychosocial dwarfism or stress dwarfism.
Dwarfism in dystrophia adiposogenitalis .
[1]. Dystrophia adiposogenitalis or Fröhlich syndrome is a pituitary disorder .
[2]. Dwarfism occurs if it develops in children.
Dwarfism in pan hypopituitarism .
Pan hypopituitarism is the pituitary disorder due to reduction in secretion of all anterior pituitary hormones. These dwarfs do not attain puberty.
2. Acromicria .
Acromicria is a rare disease in adults characterized by the atrophy of the extremities of the body.
Causes of Acromicria .
Deficiency of GH in adults causes acromicria. The secretion of GH decreases in the following conditions:
[1]. Deficiency of GH-releasing hormone from hypothalamus .
[2]. Atrophy or degeneration of acidophilic cells in the anterior pituitary
[3]. Tumor of chromophobes: It is a non-functioning tumor, which compresses and destroys the normal cells secreting the GH. This is the most common cause for hyposecretion of GH leading to acromicria
[4]. Pan hypopituitarism: In this condition, there is a reduction in secretion of all the hormones of anterior pituitary gland. Acromicria is associated with other symptoms due to the deficiency of other anterior pituitary hormones.
Signs and symptoms of Acromicria .
[1]. Atrophy and thinning of extremities of the body, (hands and feet) are the major symptoms in acromicria
[2]. Acromicria is mostly associated with hypothyroidism
[3]. Hyposecretion of adrenocortical hormones also is common in acromicria
[4]. The person becomes lethargic and obese
[5]. There is loss of sexual functions.
3. Simmond Disease .
Simmond disease is a rare pituitary disease. It is also called pituitary cachexia.
Causes of Simmond Disease .
It occurs mostly in pan hypopituitarism, i.e. hyposecretion of all the anterior pituitary hormones due to the atrophy or degeneration of anterior pituitary.
Symptoms of Simmond Disease .
1. A major feature of Simmond disease is the rapidly developing senile decay. Thus, a 30- years-old person looks like a 60-years-old person. The senile decay is mainly due to deficiency of hormones from target glands of anterior pituitary, i.e. the thyroid gland, adrenal cortex and the gonads
2. There is loss of hair over the body and loss of teeth
3. Skin on face becomes dry and wrinkled. So, there is a shrunken appearance of facial features. It is the most common feature of this disease.
Hyperactivity of Posterior pituitary .
Syndrome of Inappropriate Hypersecretion of Antidiuretic Hormone (SIADH) .
SIADH is the disease characterized by loss of sodium through urine due to hypersecretion of ADH.
Causes of SIADH .
[1]. SIADH occurs due to cerebral tumors, lung tumors and lung cancers because the tumor cells and cancer cells secrete ADH.
[2]. In normal conditions, ADH decreases the urine output by facultative reabsorption of water in distal convoluted tubule and the collecting duct.
[3]. Urine that is formed is concentrated with sodium and other ions.
[4]. Loss of sodium decreases the osmolarity of plasma, making it hypotonic.
[5]. Hypotonic plasma inhibits ADH secretion resulting in restoration of plasma osmolarity.
[6]. However, in SIADH, secretion of ADH from tumor or cancer cells is not inhibited by hypotonic plasma. So there is continuous loss of sodium, resulting in persistent plasma hypotonicity.
Signs and Symptoms of SIADH .
1. Loss of appetite .
2. Weight loss .
3. Nausea and vomiting .
4. Headache .
5. Muscle weakness, spasm and cramps .
6. Fatigue .
7. Restlessness and irritability.
In severe conditions, the patients die because of convulsions and coma.
Hypoactivity of Posterior Pituitary .
Diabetes Insipidus .
Diabetes insipidus is a posterior pituitary disorder characterized by excess excretion of water through urine.
Causes of Diabetes insipidus .
This disorder develops due to the deficiency of ADH, which occurs in the following conditions:
[1]. Lesion (injury) or degeneration of supraoptic and paraventricular nuclei of hypothalamus
[2]. Lesion in hypothalamo-hypophyseal tract
[3]. Atrophy of posterior pituitary
[4]. Inability of renal tubules to give response to ADH hormone. Such condition is called nephrogenic diabetes insipidus .
Signs and symptoms Diabetes insipidus .
1. Polyuria:
[1]. Excretion of large quantity of dilute urine, with increased frequency of voiding is called polyuria. [2]. Daily output of urine varies between 4 to 12 liter.
[3]. In the absence of ADH, the epithelial cells of distal convoluted tubule in the nephron and the collecting duct of the kidney become impermeable to water.
[4]. So, water is not reabsorbed from the renal tubule and collecting duct, leading to loss of water through urine.
2. Polydipsia:
[1]. Intake of excess water is called polydipsia. Because of polyuria, lot of water is lost from the body
[2]. It stimulates the thirst center in hypothalamus, resulting in intake of large quantity of water.
3. Dehydration:
[1]. In some cases, the thirst center in the hypothalamus is also affected by the lesion.
[2]. Water intake decreases in these patients and loss of water through urine is not compensated. So, dehydration develops which may lead to death.
Nephrogenic diabetes insipidus .
[1]. Nephrogenic diabetes insipidus is a genetic disorder due to inability of renal tubules to give response to ADH.
[2]. It is caused by mutations of genes of V2 receptors or aquaporin 2.
Hypoactivity of Anterior & Posterior Pituitary .
Dystrophia Adiposogenitalis .
[1]. Dystrophia adiposogenitalis is a disease characterized by obesity and hypogonadism, affecting mainly the adolescent boys.
[2]. It is also called Fröhlich syndrome or hypothalamic eunuchism.
Causes of Dystrophia adiposogenitalis .
[1]. Dystrophia adiposogenitalis is due to hypoactivity of both anterior pituitary and posterior pituitary. [2]. Common cause of this disease is the tumor in pituitary gland and hypothalamic regions, concerned with food intake and gonadal development.
[3]. Other causes are injury or atrophy of pituitary gland and genetic inability of hypothalamus to secrete luteinizing hormone-releasing hormone.
Symptoms of Dystrophia adiposogenitalis .
[1]. Obesity is the common feature of this disorder. Due to the abnormal stimulation of feeding center, the person overeats and consequently becomes obese.
[2]. Obesity is accompanied by sexual infantilism (failure to develop secondary sexual characters) or eunuchism.
[3]. Dwarfism occurs if the disease starts in growing age. In children, it is called infantile or prepubertal type of Fröhlich syndrome. This disease develops in adults also.
[4]. When it occurs in adults, it is called adult type of Fröhlich syndrome. In adults, the major symptoms are obesity and atrophy of sex organs.
[5]. Other features of this disorder are behavioral changes and loss of vision. Some patients develop diabetes insipidus.
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