Hyperpituitarism

Symptoms caused by hormone excess and associated mass effects include:

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• Acromegaly
• Cushing's disease
• Hirsutism
• Visual field loss or double vision{{Cite book |last=Wendy |url=https://books.google.com/books?id=dIMHnjf0MmoC&q=Hyperpituitarism+can+cause+double+vision&pg=PA595 |title=Medical-surgical nursing : an integrated approach |date=2013 |publisher=Delmar Cengage Learning |isbn=978-1-4354-8802-1 |edition=3rd |location=Clifton Park, NY |page=595 |access-date=26 August 2015}}
• Excessive sweating
• Decreased libido{{Cite book |last=Hales |first=Robert E. |url=https://books.google.com/books?id=f5BEk-6yO_4C&q=cushing%27s+syndrome++symptoms&pg=PA814 |title=The American Psychiatric Publishing textbook of neuropsychiatry and behavioral neurosciences |date=2007 |publisher=American Psychiatric Pub. |isbn=978-1-58562-239-9 |edition=5th |location=Washington, DC |page=815 |access-date=26 August 2015}}
• Lethargy
• Headache{{Cite web |title=Prolactinoma |url=https://www.nlm.nih.gov/medlineplus/ency/article/000336.htm |url-status=live |archive-url=https://web.archive.org/web/20160705124317/https://www.nlm.nih.gov/medlineplus/ency/article/000336.htm |archive-date=5 July 2016 |access-date=26 August 2015 |website=MedlinePlus |publisher=NIH}}
• Male lactation
• Muscle weakness
• Bruisability

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The cause of hyperpituitarism in most cases is due to pituitary adenomas. They usually come from the anterior lobe, are functional and secrete the hormone, GH and prolactin.{{Cite book |last=Kumar |first=Vinay |url=https://books.google.com/books?id=jJllBAAAQBAJ |title=Robbins and Cotran Pathologic Basis of Disease, Professional Edition: Expert Consult - Online |last2=Abbas |first2=Abul K. |last3=Fausto |first3=Nelson |last4=Aster |first4=Jon C. |date=2014-08-27 |publisher=Elsevier Health Sciences |isbn=9780323296397}}

Image:Somatotropine.GIF

Evidence indicates that the mechanism of hyperpituitarism can originate from genetic disruption causing pituitary tumorigenesis, most pituitary adenomas are monoclonal, which in turn indicates their origin from an event in a single cell. There are three hormones that are oversecreted resulting in the pituitary adenoma: prolactin, adrenocorticotropic hormone (ACTH), and growth hormone (GH).{{medical citation needed|date=August 2015}}

Excess prolactin may result in a prolactinoma{{Cite web |date=2014 |title=Prolactinoma |url=http://www.niddk.nih.gov/health-information/health-topics/endocrine/prolactinoma/Pages/fact-sheet.aspx |url-status=dead |archive-url=https://web.archive.org/web/20170210192105/https://www.niddk.nih.gov/health-information/health-topics/endocrine/prolactinoma/Pages/fact-sheet.aspx |archive-date=10 February 2017 |access-date=26 August 2015 |website=NIH}} Excess GH results in gigantism, the severity of gigantism depends on whether the epiphyseal plate is open.{{EMedicine|article|925446|Gigantism and Acromegaly}} The four most common types of hyperpituitarism are caused by 4 types of pituitary adenoma, as follows: prolactinoma, corticotropinoma (Cushing's disease), somatotropinoma (gigantism), and thyrotropinoma .{{Cite book |last=Aguirre |first=Alfredo |title=Cellular Endocrinology in Health and Disease |publisher=Elsevier |year=2014 |isbn=978-0-12-408134-5 |page=24}}

For the diagnosis of hyperpituitarism it depends on the cell type(s) affected, clinical manifestations of hormone excess may include, gigantism or acromegaly, which can be identified by clinical and radiographic results.{{Cite web |date=2014 |title=Acromegaly |url=http://www.niddk.nih.gov/health-information/health-topics/endocrine/acromegaly/Pages/fact-sheet.aspx |url-status=dead |archive-url=https://web.archive.org/web/20170210213951/https://www.niddk.nih.gov/health-information/health-topics/endocrine/acromegaly/Pages/fact-sheet.aspx |archive-date=10 February 2017 |access-date=28 August 2015 |website=NIH |publisher=National Institute of Diabetes and Digestive, Kidney Disease}} Cushing's disease diagnosis is done with a physical examination, laboratory tests and MRI of the pituitary gland (to locate tumors){{Cite web |title=Cushing's Syndrome |url=http://www.niddk.nih.gov/health-information/health-topics/endocrine/cushings-syndrome/Pages/fact-sheet.aspx |url-status=live |archive-url=https://web.archive.org/web/20170210192202/https://www.niddk.nih.gov/health-information/health-topics/endocrine/cushings-syndrome/Pages/fact-sheet.aspx |archive-date=2017-02-10 |access-date=2015-08-25 |website=www.niddk.nih.gov}} For prolactinoma, diagnosis comes in the form of the measurement of serum prolactin levels and MRI of pituitary gland.{{Cite book |last=Laws |first=Edward |url=https://books.google.com/books?id=-Tnrm_scuL8C&q=prolactinoma%2520diagnosis&pg=PT388 |title=Pituitary Disorders: Diagnosis and Management |last2=Ezzat |first2=Shereen |last3=Asa |first3=Sylvia |last4=Rio |first4=Linda |date=2013-02-21 |publisher=John Wiley & Sons |isbn=9781118559376}}

File:Dopamine2.svg

Treatment (for hyperpituitarism) in the case of prolactinoma consists of long-term medical management. Dopamine agonists are strong suppressors of PRL secretion and establish normal gonadal function. It also inhibits tumor cell replication (in some cases causes tumor shrinkage){{EMedicine|article|921568|Hyperpituitarism|treatment}} Treatment for gigantism begins with establishing target goals for IGF-1, transsphenoidal surgery (somatostatin receptor ligands- preoperatively) and postoperative imaging assessment.{{Cite web |title=National Guideline Clearinghouse {{!}} Acromegaly: an Endocrine Society clinical practice guideline. |url=https://www.guideline.gov/content.aspx?id=49121 |url-status=dead |archive-url=https://web.archive.org/web/20150907235850/http://www.guideline.gov/content.aspx?id=49121 |archive-date=2015-09-07 |access-date=2015-08-25 |website=www.guideline.gov}} For Cushing's disease there is surgery to extract the tumor; after surgery, the gland may slowly start to work again, though not always.{{MedlinePlusEncyclopedia|000348|Cushing disease}}

• Hypopituitarism

{{Reflist}}

• {{Cite book |url=https://books.google.com/books?id=vCzlLiOlVeUC |title=Handbook of Medical-surgical Nursing |date=2006-01-01 |publisher=Lippincott Williams & Wilkins |isbn=9781582554457}}
• {{Cite journal |last=Atreja |first=Gaurav |last2=Jain |first2=Nitul |last3=Atreja |first3=ShikhaHanda |last4=Sukhija |first4=Urvashi |year=2012 |title=Oral manifestations in growth hormone disorders |journal=Indian Journal of Endocrinology and Metabolism |volume=16 |issue=3 |pages=381–3 |doi=10.4103/2230-8210.95678 |pmc=3354844 |pmid=22629503 |doi-access=free}}
• {{Cite book |url=https://archive.org/details/illustratedmanua0000unse |title=Illustrated Manual of Nursing Practice |date=2002-01-01 |publisher=Lippincott Williams & Wilkins |isbn=9781582550824 |url-access=registration}}

{{Medical resources

| DiseasesDB =

| ICD11 = {{ICD11|5A60}}

| ICD10 = {{ICD10|E|22||e|20}}

| ICD9 = {{ICD9|253.1}}

| ICDO =

| OMIM =

| MedlinePlus =

| eMedicineSubj = ped

| eMedicineTopic = 1092

| MeshID = D006964

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{{Commons}}

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{{Pituitary disease}}

Category:Pituitary disorders