The concept of the hypothalamic-pituitary insufficiency
Syndrome of hypothalamic-pituitary insufficiency(Hypopituitarism) - a disease characterized by a decrease and loss of function of the pituitary and hypothalamus. The pituitary gland consists of two lobes of the front and rear. The anterior pituitary lobe occurs production of six hormones (ACTH, prolactin, growth hormone, follitropin, lutropin and thyrotropin). If hypopituitarism production of pituitary hormones decreases dramatically or disappears. As a result of sharply reduced function peripheral endocrine glands, which control the operation of the pituitary hormones.
Hypopituitarism can be primary, whendestroyed or missing hormone-producing cells of the pituitary gland, and the secondary, if the failure to give the hypothalamus pituitary disease or central nervous system. Sometimes there is insufficient production of hormones from the pituitary gland.
Reasons gipopituitarnogo syndrome may include:
- hypophyseal adenoma
- tumors of the pituitary and the hypothalamus and other parts of the central nervous system
- Shyullera disease
- inflammatory diseases of the brain
- vascular disorders in the arteries supplying the pituitary and hypothalamus
- autoimmune diseases
- brain injury
- metabolic disorders in diabetes mellitus
- prolonged fasting
- anorexia nervosa
- chronic renal and liver failure
By the failure of the pituitary gland can leadanomalies of pituitary development. In the postpartum period in pathological childbirth may occur necrosis (death) of the anterior pituitary. When complete necrosis of the anterior lobe of a condition called syndrome Simmonds, during partial - syndrome Skien. When gipopituitarnom syndrome is the destruction of hormone-producing cells of the anterior pituitary.
The main symptoms of the disease
The manifestations of hypopituitarism occur whenfunctioning cells is less than 10%. The disease usually develops gradually over many years. The earliest sign of the disease is usually insufficient by the gonadotrophic pituitary function - reducing the number of pituitary hormones regulate the function of sexual glands.
If hypopituitarism originated in childhood or hashereditary nature, disrupted development in puberty. Puberty is delayed, formed eunuchoid body proportions, delayed skeletal growth.
In adolescence, secondary sexual characteristics gradually erased:
- reduced body hair in the armpits and pubic
- slowing the growth of beards and mustaches
- decrease in the size of the testicles and prostate gland
- muscle tissue atrophies and is replaced by fat
In girls, disrupted menstrual cycle, decrease breasts, thinner fabric genitals.
One of the early signs of hypopituitarism - a violation of the sense of smell.
Insufficient production of growth hormone (GH) in children is manifested growth retardation.
Reduced hormone production leads tirotropnogoin childhood to the failure of the thyroid gland function and delayed mental and physical development, there is hypothyroidism. Patients usually normal diet, weight loss rarely happens. There are complaints of weakness. They have low blood pressure, slow heart rate, often have gastrointestinal disorders.
When pituitary tumors arise complaints of the central nervous system - headache, visual disturbances. Detected constriction of visual fields, and changes in the fundus.
Very rare acute hypopituitarism syndrome, when there is bleeding in the pituitary gland and occur:
- sudden headache
- sudden fall of
- drop in blood pressure
- loss of consciousness
Methods of treatment of hypopituitarism
Treatment of the syndrome of hypopituitarism conducted taking into account the disease, which led to the failure of the pituitary gland. When tumors treatment is usually surgical or radiation.
To correct the deficiency of hormones functionpituitary assigned different medicated preparations based on the prevalence of deficiency of certain hormones. At insufficiency of adrenocorticotropic hormone prescribed synthetic adrenocortical hormones - glucocorticoids:
In male adolescents during puberty appointed chorionic gonadotropin.
At insufficiency of thyroid function are treated with thyroid hormone.
Sometimes it is necessary to appoint a growth hormone preparations.
With timely detection of illness and initial treatment, patients can lead a normal life and maintain the ability to work for a long time.