Introduction
Pituitary diseases are the diseases that involve pituitary gland. The pituitary gland is of 1 gram approximately. It is divided into anterior and posterior lobes. It is found in a bony socket of skull. It’s an endocrine which works in coordination with other glands of body but it has the power to control many of them. Its relations anatomically are important as said for cavernous sinus, carotids and optic chiasmi being most important. Vascular, tumorous or physical problems are most common pituitary diseases. Pituitary gland works under the control of hypothalamus after it has assessed the body’s physiology and pathology if any present. Any pathology that interferes with this mechanism can cause pituitary diseases. Anterior lobe controls production of growth hormone, thyroid gland working, gonadal hormones, breast, adrenals and many other organs.
History
Most common pituitary diseases are as follows:
Excess or deficient hormone release controlling factors from pituitary are the reason that alters the normal physiological environment of body or sometimes the altered environment that leads to pituitary diseases.
Pituitary tumors:
Tumors in pituitary or outside it may compress may cause tumorigenic pituitary diseases. The cancers can be micro-adenomas or macro ones. These can be a part of multiple endocrine neoplastic types 1. Symptoms can be, headache, eyesight problems, hypothalamic syndrome, diabetes insipidus, SIADH, hydrocephalus or disturbed sleep, thirst, appetite etc. these can be diagnosed via symptoms and through investigations for pituitary diseases.
Hypopituitarism:
In pituitary diseases the low production of growth hormone can cause stunted growth, the reduced levels of gonadotropins may result in altered sexual activity and process related to that such as infertility. The decreased levels of corticotropin, Thyrotropin and lactotropin may cause by mineralocorticoid deficiency, thyroid hormone deficiency and lactation problems. Serious body function derangements may occur in such pituitary diseases.
Hyper secretion of pituitary:
In pituitary diseases with excess of hormone releasing factors production may cause hyper-pro-lactenemia. It is opposite to the hypopituitarism state. This causes acromegaly, in which the patient has goiter, carpel tunnel syndrome, skeletal enlargement, hypertension, CHF, excess sweating and impaired glucose tolerance. Insomnia, hyper prolactin secretion and thick coarse skin are seen in patients of such pituitary diseases. In Cushing’s the patient is obese, has myopathy, facial plethoric, easy bruising and osteoporosis with hypokalemia. Hyperthyroid state and goiter results in these pituitary diseases.
Features
Nonfunctional adenomas:
These are the most common in pituitary diseases. They usually secrete glycoprotein or its subunits. The symptoms are due to this kind of mass effect in pituitary diseases. Headaches and visual defects are common. In all these condition an MRI must be ordered and levels of hormone releasing factors are done due to known derangements in pituitary diseases.
Inflammatory lesions:
An inflammatory lesion among pituitary diseases is lymphocytic hypophysitis . It is rare and is seen in post-partum ladies due to sudden shrinkage in blood supply to pituitary. Corticotropin deficiency is seen in such pituitary diseases. It ultimately affects the working of adrenal glands. Sometimes pituitary is found to be absent.Pituitary apoplexy:
In pituitary diseases, this is an emergency though rare but important. Headache, visual problems, ocular palsy, nausea, mental altered status and fever are the most important signs present. This occur secondary to haemorrhage. It is treated by steroids and MRI scan is done.
Common Disease
Diabetes insipidus:
Chronic excretion of large volume of urine is characterized by calling it diabetes insipidus as in pituitary disease. It’s an underdiagnosed condition use by congenital, trauma and multiple other causes. It can be central, peripheral or gestational. ADH analogue is given to treat this pituitary diseases.
