RESUMO
Deficiency of the anterior lobe of the pituitary due to disease in the pituitary-hypothalamic area may involve any or all pituitary hormones to varying degrees but, usually, growth hormone (GH) and gonadotropins (FSH and LH) are more commonly affected than thyrotropin (TSH), corticotropin (ACTH) and prolactin. Of these 6 hormones TSH and ACTH are of life sustaining importance.
Assuntos
Hipopituitarismo/diagnóstico , Hormônios Hipofisários/análise , Humanos , Adeno-HipófiseRESUMO
The most consistent biochemical thyroid abnormality associated with age, various illnesses, and drugs is the low T3 syndrome due to decreased activity of 5'-deiodinase. Lower T3 levels may help reduce the catabolic effects of illness on the individual. The diagnosis of hypothyroidism can be missed in the elderly when its typical manifestations are attributed to aging. The diagnosis of hyperthyroidism in the elderly may likewise be difficult because of atypical clinical presentations. A high index of clinical suspicion should lead to a timely diagnosis of these eminently treatable disorders.
Assuntos
Envelhecimento , Doenças da Glândula Tireoide/metabolismo , Glândula Tireoide/fisiologia , Idoso , Síndromes do Eutireóideo Doente/diagnóstico , Síndromes do Eutireóideo Doente/metabolismo , Síndromes do Eutireóideo Doente/terapia , Humanos , Hipertireoidismo/diagnóstico , Hipertireoidismo/metabolismo , Hipertireoidismo/terapia , Hipotireoidismo/diagnóstico , Hipotireoidismo/metabolismo , Hipotireoidismo/terapia , Doenças da Glândula Tireoide/diagnóstico , Doenças da Glândula Tireoide/terapia , Testes de Função Tireóidea , Tireotropina/metabolismo , Hormônio Liberador de Tireotropina/metabolismoRESUMO
A 13-year-old boy was evaluated for an enlarged sella. There were no consistent visual field defects, and carotid arteriograms and pneumoencephalograms showed no extrasellar abnormality. The endocrine workup demonstrated a subnormal growth hormone reserve. The only other, but most striking abnormality, was an excessively high serum prolactin level, which was partially suppressed with levodopa. A chromophobe pituitary tumor was removed that had histological features suggestive of malignant neoplasm. Characteristics of a prolactin-secreting tumor were confirmed by electron microscopy. The serum prolactin levels decreased substantially after surgery and further after a course of pituitary irradiation; however, they continue to be elevated above normal. Prolactin determinations play in integral part in the evaluation for a possible pituitary tumor-not only for diagnostic purposes, but also to provide a parameter of future tumor activity in an established case. Electron microscopical studies are helpful in identifying the tumor as source of the excessive prolactin secretion.
