Treatment of anterior pituitary insufficiency
Endocrinology / / August 12, 2017
For those patients who diagnosed the disease process in dientsefalogipofizarnoy region, which led to the anterior pituitary insufficiency, the treatment should be carried out of the main disease - surgical removal or radiation therapy in the case of a tumor, anti-inflammatory treatment of an infectious process.During the surgery, or radiation therapy must be particularly careful to clarify the functional state of the adrenal cortex and adrenocorticotropic reserves the anterior pituitary gland and ensure the introduction of adequate doses of cortisone to prevent acute adrenal insufficiency, which may occur not only during operation, but also during radiotherapy.The doses of cortisone during surgical interventions should be the same as during operations in patients with Addison's disease .
At the same time in these patients, as well as in patients with postpartum hypopituitarism, and those who have not clarified the primary pathogenetic link in the development of anterior pituitary insufficiency, it is
In those cases where the clinical picture is dominated by symptoms of hypothyroidism, and signs of adrenal insufficiency are not expressed, it is necessary to bear in mind that the treatment of thyroid drugs can detect adrenal insufficiency.Therefore, simultaneously with the appointment of thyroid preparations should begin treatment with cortisone or cortisol.
Patients with predominant loss of adrenocortical function even in the presence of symptoms of hypothyroidism careful administration of thyroid preparations should be done only after the hypocorticoidism.
gipopituitarnoy coma Treatment should be conducted primarily with high doses of corticosteroids (cortisone to 300 mg per day intramuscularly).Although signs of thyroid insufficiency in gipopituitarnoy coma requires great care in assignment of thyroid hormones, since they can lead to increased adrenal failure and hypoglycemia.
patients who, in addition to failure of the anterior pituitary, has diabetes insipidus, during treatment with corticosteroids and tireoidinom enhanced polyuria and thirst.This can make the necessary appointment adiurecrine (0.03-0.05 for the three times daily intranasal), those patients who did not receive it before.
- Pathological Anatomy at the failure of the anterior pituitary
- deficiency of the anterior pituitary.The clinical picture
- deficiency of the anterior pituitary.These hormonal studies
- deficiency of the anterior pituitary.The disease
- deficiency of the anterior pituitary.Diagnosis and differential diagnosis
forecast and disabled
forecast disease caused by inflammatory or neoplastic process in dientsefalo-pituitary region, depends primarily on the nature and dynamicsthis pathological process.In the case of a radical cure the underlying disease, for example, after the removal of cysts or tumors, disease progression is stopped and can occur partial restoration of function of the anterior pituitary.
prognosis for recovery from postpartum hypopituitarism unfavorable.The disease tends to progression.In the absence of proper treatment of postpartum hypopituitarism may cause the death of the patients, which occurs either due to acute adrenal insufficiency or with symptoms gipopituitarnoy coma.
When properly conducted life and relative compensation for replacement therapy patients can be stored for many years.However, the achievement of full compensation in these patients is more complex than in patients with isolated deficiency of the adrenal cortex and thyroid gland.
Employability of patients with deficiency of the anterior pituitary function is reduced.In the case of tumor or inflammation in the area of the pituitary-dientsefalo degree of disability is determined by not only the degree of decrease of hormonal function of the anterior pituitary, and other disorders associated with the main pathological process.Typically, such patients should be transferred to the Group II disability.
patients are also inoperative In severe postpartum hypopituitarism with symptoms of adrenal insufficiency and thyroid.At the "erased" forms of the disease, when it is possible to assume the existence of "latent" period, even in the absence of pronounced signs of adrenal insufficiency, it should be borne in mind that this failure may become apparent under stress.Therefore, these patients are limited and need to be workable employment - providing work without occupational hazards, do not require significant physical and mental stress.