18 Diseases of the Endocrine Glands
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Transcript of 18 Diseases of the Endocrine Glands
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Diseases of the Endocrine
Glands
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Major Determinants of Disease
Many endocrine organs are controlled by the pituitary gland Nonendocrine conditions can cause excessive production of
endocrine hormones
Overstimulation of target organs by pituitary hormones leadsto enlargement of the target organs & overproduction of its
hormones Overproduction of endocrine hormones accounts for most of
the manifestations of endocrine disease
Overproduction of hormones may be caused by hyperplasiaor neoplasia of endocrine glands
Underproduction of hormones is usually caused by disease ofthe target organ, rather than to failure of hormone stimulation
Pituitary tumors may cause symptoms by pressing onadjacent structures (mass effect), not necessarily byproducing hormones
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Pituitary Diseases
Most often anterior lobe
Mass such as a neoplasm is most commondisease
Masses have 2 consequences besides hormoneproduction mass effect
pressure on nearby structures
intracranial pressure
stalk effect interference with hypothalamic inhibition of prolactinsecretion
Most common mass is an adenoma
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Hyperpituitarism
Mostly from adenomas
usually single cell type
most are functioning
secrete single hormone
more common in men
usually discrete nodules
excessive hormone
production, mass effect,
stalk effect
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Growth Hormone Adenoma
2ndmost common functioning adenoma
Subtle manifestations initially
Causes gigantism
acromegaly
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Sheehan Syndrome
Infarction of pituitary
in pregnancy
enlarges mostly due to
prolactin secretingcells
not enough blood
supply
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Diabetes Insipidus
High output of very dilute urine
Destruction of pituitary or conditions affecting thehypothalamus
head trauma surgery
neoplasm
infarction
inflammation Genetic defects of ADH synthesis
Renal defect
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Hyperthyroidism
Increased metabolic rate (thyrotoxicosis)
Causes
overmedication in thyroid gland failure
increased hormone due to thyroid gland
diseasesprimary
increased hormone due to TSH - secondary
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Graves Disease
80-90% of all hyperthyroidism
One of most common autoimmune
diseases in US
Mostly women
Antibody that acts like TSH
Gland is diffusely enlarged & smooth
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Hypothyroidism
Usually primary
Could by due to lack of dietary iodine
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Nontoxic goiter
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Nodular goiter
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Thyroiditis
Inflammation of thyroid
Mostly chronic
autoimmune
Presents as goiter
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Hasimoto Thyroiditis
Most common type in
US
One of most common
causes of goiter &hypothyroidism
Antibodies that block
TSH
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Neoplasms of Thyroid Gland
Not common
Neoplastic masses are more likely to
be solitary masses
cold
in younger patients
in males
Most are from nodular goiter
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Primary Hyperparathyroidism
Important cause ofhypercalcemia
stones, bones,
groans, & moans Most patients have
lab disease only
elevated Ca2+
&PTH
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Secondary Hyperparathyroidism
Due to chronic renal failure
Hyperplasia of parathyroids induced by highblood PO4
-& decreased blood Ca2+
Clinical findings HTN
anemia
edema
low urine output Transplant usually corrects; if persists have
tertiary hyperparathyroidism
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Hypoparathyroidism
Usually caused by inadvertant surgical
removal
Major abnormality is low blood Ca2+
tetany
tingling sensations
muscle spasms
seizures
Treated with vit D & Ca2+
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Cushing Syndrome
Excessive
cortisol
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Acute Adrenocortical Crisis
Fatal without cortisol replacement Sudden withdrawal of corticosteroid therapy
probably most common cause
drugs suppress ACTH
adrenal atrophy Bilateral acute hemorrhagic infarction of adrenal
gland most common cause is acute meningococcal
meningitis Sudden worsening of chronic adrenalinsufficiency undiagnosed patient suddenly stressed
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Pheochromocytoma
Secrete catecholamines which canproduce severe HTN
Rule of 10s
10% arise outside the adrenal 10% of those in adrenal are bilateral
10% are malignant
10% arise in children 10% occur in association with other endocrineneoplasms