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Evaluation and Investigation of Pituitary Disease
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
A pituitary macroadenoma may exert mass effect on surrounding structures. Pressure on the optic chiasm due to suprasellar extension of the tumour initially leads to a bitemporal superior quadrantanopia, followed by bitemporal hemianopia. The visual field defect may be asymmetrical. The patient may be unaware of the visual field defect or may complain of nonspecific symptoms, such as clumsiness. Less commonly, lateral expansion into the cavernous sinus may lead to diplopia and ophthalmoplegia. Large pituitary adenomas may cause headaches and rarely hydrocephalus due to obstruction of the third ventricle. Headache is a common presenting symptom in pituitary disease but cannot always be attributed to the tumour.
Endocrinology, growth and puberty
Published in Rachel U Sidwell, Mike A Thomson, Concise Paediatrics, 2020
Rachel U Sidwell, Mike A Thomson
Pituitary tumours constitute an important cause of pituitary disease, and they include the following conditions: CraniopharyngiomaCushing syndrome (see p. 239)Non-functioning tumourProlactinomaPituitary gigantismNelson syndrome
Endocrine system
Published in Aida Lai, Essential Concepts in Anatomy and Pathology for Undergraduate Revision, 2018
Adrenal insufficiency Inadequate secretion of cortisol and aldosteroneCauses: primary (increased levels of ACTH): – autoimmune– TBsecondary (reduced levels of ACTH): – pituitary diseaseSymptoms: – fatigue– hypotension
Quality of life of patients with acromegaly: comparison of different therapeutic modalities
Published in Expert Opinion on Orphan Drugs, 2022
Yanitsa Rusenova, Silvia Vandeva, Atanaska Elenkova, Guenka Petrova, Maria Kamusheva
Worse QoL has been reported to be in correlation with various factors such as female gender [18]. Similarly, Bulgarian women with acromegaly had lower AcroQoL scores than men (p < 0.05), which is in accordance with a previous Bulgarian cross-sectional and longitudinal study by Vandeva et al. [14]. In general, pituitary disease impairs significantly QoL especially in female patients [22]. Such observation is described for other medical conditions – quality of life among women after myocardial infarction was significantly lower than men [23,25]. However, other studies have not found any significant difference in QoL between males and females [8,19,26,27]. More specific population-based studies for the Bulgarian patients are needed to distinguish the main reasons for these gender-based differences in QoL.
Peripheral clock system circadian abnormalities in Cushing’s disease
Published in Chronobiology International, 2020
Vinicius Reis Soares, Clarissa Silva Martins, Edson Zangiacomi Martinez, Leonardo Domingues Araujo, Silvia Liliana Ruiz Roa, Lucas Ravagnani Silva, Ayrton Custodio Moreira, Margaret De Castro
All CD patients presented ACTH-dependent Cushing syndrome, with high (n = 11) or normal (n = 1) ACTH levels (16.4 ± 6.5 pmol/L; normal range: 2.2–11 pmol/L). All patients underwent MRI, 8 out of 12 patients presented microadenoma, 3 out of 12 macroadenoma, and one showed no visible pituitary tumor. All patients, except one, presented an ACTH and/or cortisol response after DDAVP (ACTH increment of 191.8 ± 254.4% and cortisol increment of 60.9 ± 37.4%). Six out of 12 patients underwent BIPSS due to small tumors or no evidence of pituitary tumor on MRI or discordant response to DDAVP test. All of them showed central/peripheral gradient, confirming the pituitary disease. Eleven CD patients were submitted to transsphenoidal surgery and six of them are in remission of disease (54.5%), five are under treatment with ketoconazole or ketoconazole and radiotherapy. Patient 10 was last evaluated in 2019 and has been followed with no transsphenoidal surgery so far.
Sheehan’s syndrome and sickle cell disease: the story of Natasha*
Published in Neuropsychological Rehabilitation, 2018
Barbara A. Wilson, Anita Rose, Gerhard Florschutz
The majority of papers published on SS do not mention psychological or neuropsycholgical sequelae. Of those that do, mood disorders are sometimes reported. One paper describes major depression in a Turkish woman with SS (Tıkır, Göka, Aydemir, & Gürkan, 2015). Looking at pituitary diseases in general, Weitzner, Kanfer, and Booth-Jones (2005) state there is a clear link between pituitary disease and psychiatric disturbance including anxiety, depression, personality change and behavioural problems. In addition, there are a few reports of psychoses in women with SS. These include a 23-year-old Indian woman (Kale, Nihalani, Karnik, & Shah, 1999), a 48-year-old Korean woman (Hong, Cho, Kang, Chung, & Chung, 2006), and a 31-year-old Iranian woman (Shoib et al., 2013). All improved with treatment. It is interesting to note here that psychiatric complications have been reported following treatment with corticosteroids (Dubovsky, Arvikar, Stern, & Axelrod, 2012; McGrath, Pun, James, & Holewa, 2007).