Is central diabetes insipidus a manifestation of pituitary insufficiency? Most patients with anterior pituitary insufficiency do not have concomitant posterior pituitary failure. However, in those in whom central diabetes insipidus is also present, craniopharyngioma, hypophysitis, metastatic cancer, and sarcoidosis should be suspected.
Pituitary Insufficiency Pituitary insufficiency, also known as hypopituitarism , is a syndrome characterized by one or more anterior pituitary hormone deficiencies as a result of aplasia or hypoplasia, destruction, infiltration, or compression of the hypothalamus and/or pituitary gland. Pituitary insufficiency can be congenital or acquired; familial or sporadic; partial or complete; and transient (reversible) or permanent. Posterior …
Symptoms of Cushings Syndrome Excessive cortisol is highly unlikely. Although the listed findings are consistent with glucocorticoid excess, they are nonspecific; most patients with such findings do not have Cushing’s syndrome. True Cushing’s syndrome is uncommon, with an incidence of two to three cases per million people per year, although it may be higher in …
Symptoms of high cortisol What are the clinical symptoms of excessive levels of cortisol? Prolonged and inappropriately high levels of cortisol lead to Cushing’s syndrome, characterized by: • Obesity, especially central (truncal) obesity, with wasting of the extremities, moon facies, supraclavicular fat pads, and “buffalo hump” • Thinning of the skin, with facial plethora, easy bruising, and …
How are cortisol levels normally regulated? Adrenal production of cortisol is stimulated by the pituitary hormone adrenocorticotropin (ACTH). ACTH production is stimulated by the hypothalamic hormones corticotropin-releasing hormone (CRH) and vasopressin (ADH). Cortisol feeds back to the pituitary and hypothalamus to suppress levels of ACTH and CRH. Under nonstress conditions, cortisol is secreted with a …
Normal function of cortisol in healthy people Cortisol and other glucocorticoids have many effects as physiologic regulators. They increase glucose production, inhibit protein synthesis and increase protein breakdown, stimulate lipolysis, and affect immunologic and inflammatory responses. Glucocorticoids are important for maintenance of blood pressure and form an essential part of the body’s response to stress.
The patient has undergone TSS for acromegaly and now has normal IGF-1 and GH levels, as well as suppressed levels of GH after oral glucose administration. How should the patient be monitored? It appears that the patient is cured, but GH tumors can slowly regrow over years. At the least, measurements of GH and IGF-1 …
How to monitor a patient who has undergone TSS for acromegaly Read More »