Insufficiency of the anterior pituitary gland : hormone research data
Endocrinology / / August 12, 2017
Isolation urine gonadotropin and estrogen dramatically lowered.17 gidroksikortikosteroidov content in the blood and isolation of 17-and 17-gidroksikortikosteroidov ketosteroids urine significantly reduced.After administration of the ACTH level 17 gidroksikortikosteroidov blood and isolation of these compounds and 17-keto steroids in urine usually rises to a lesser extent than in healthy individuals, but significantly more than that of patients with primary chronic adrenocortical insufficiency.When a long-term decrease in the function of the anterior pituitary with a complete or nearly complete cessation of release of adrenocorticotropic hormone in some patients almost completely disappears adrenocortical response to ACTH stimulation.For example, in one case, the patient postpartum hypopituitarism after 2, 6, 24 and 30 months after the onset of the disease was observed satisfactory adrenal response to ACTH administration, manifests as clinical improvement - the disappearance of the symptoms of adrenal in
To reveal hidden reserves failure adenokortikotropnyh anterior pituitary proposed test with SU-4885 (metapyron).This substance inhibits 11 B -gidroksilazu in the adrenal cortex, thereby inhibiting the production of cortisol.Lowering the levels of cortisol in the blood leads to increased secretion of the anterior lobe of the pituitary ACTH, under the influence of which the adrenal glands produce a large number of 11-deoxycortisol;last detected in the urine and in the blood of 17-hydroxycorticosteroids.SU-4885 patients given orally at a dose of 500-750 mg 4-6 times a day for two days.If the ability of the anterior pituitary gland to increase the production of ACTH in response to a decrease in production of cortisol by the adrenal glands is not broken, the level of the 17-Oksikort kosteroidov in the blood and excretion of urine increases due to increased secretion of adrenal 11-deoxycortisol.Patients who adrenocorticotropic reserves the anterior pituitary reduced, improving 17 glucocorticoids does not occur.
These studies of thyroid function in patients with postpartum hypopituitarism, as well as in patients after the removal of the pituitary gland, are some of the features.A significant proportion of patients there is a decrease of all indicators of activity of the thyroid gland - basal metabolism, the concentration of iodine in the blood associated with the protein, and the capture of radioactive iodine by the thyroid gland.Along with this, in some patients with clinical signs of hypothyroidism low basal metabolic rate and low iodine content associated with a protein capture radioiodine normal thyroid.In patients with reduced capture radioiodine uptake of thyroid stimulating hormone after administration is increased to a lesser extent than in healthy people, but greater than that of patients with primary hypothyroidism.
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case of insufficiency of the anterior lobe of the pituitary caused intrasellyarnoy tumor, as well as in patients with postpartum hypopituitarism, production decrease symptomsanterior pituitary hormones may occur simultaneously.Often the first symptom, which in a slow-growing tumor can be preceded by many years the other manifestations of the disease, is a violation of the production of gonadotropins.This manifests itself in violation of the menstrual cycle in women, impotence in men.Later, join the symptoms of adrenal insufficiency and thyroid.These patients are often absent pallor peculiar to patients postpartum hypopituitarism, sometimes increased skin pigmentation.