What we will cover. Evaluation of the Child with Suspected Pituitary Disease. ituitary

Size: px
Start display at page:

Download "What we will cover. Evaluation of the Child with Suspected Pituitary Disease. ituitary"

Transcription

1 Evaluation of the Child with Suspected Pituitary Disease Craig Alter, MD University of Pennsylvania Children s Hospital of Philadelphia What we will cover * What laboratory tests to order * MRI: common pituitary findings * Diabetes Insipidus * Craniopharyngioma * Prolactinoma ituitary 1

2 Pituitary Hormones Pituitary Hormones LH, FSH TSH GH Prolactin ACTH ADH (Vasopressin) Oxytocin 2

3 Pituitary Labs LH, FSH: ultrasensitive or pediatric assay testosterone, estradiol TSH: free-t4, TSH, not TSH alone GH: IGF-1, IGFBP3 Prolactin may need serial dilutions ACTH 730-8am fasting cortisol ADH (Vasopressin): fasting Ur Osm, Osm, Chem panel 3

4 IGF-1 pending 4

5 37 ng/ml (very low!) IGF-1 MRI Findings: * Mass in the pituitary * Absent posterior pit bright spot * Considerations: craniopharyngioma, Rathke s cleft cyst, adenoma Pituitary Diagnoses Craniopharyngioma Rathke s Cleft cyst Pars intermedia cyst Hamartoma Gem Cell tumors (germinoma) Histiocytosis Adenoma, Prolactinoma Optic nerve hypoplasia Ectopic Posterior Pituitary 5

6 Pituitary Diagnoses Craniopharyngioma: calcifications, CT can help, benign, cysts can recur after surgery Rathke s Cleft cyst Pars intermedia cyst: small, < 3 mm, benign Hamartoma: associated with precocity Gem Cell tumors (germinoma) -DI Histiocytosis (DI) Adenoma, Prolactinoma Optic nerve hypoplasia Growing poorly Next patient Delayed puberty Perhaps adrenal insufficiency symptoms Drinks a great deal, nocturia Breast discharge Fatigue Visual complaints, headaches Just get the MRI already!! 6

7 7

8 Case David Ingelfinger *14 6/12 male polydipsia/uria *6 months increased thirst *Up 9 times/night * Urine: 8 liters/day *Failed trial restriction Review of Systems DI *Rare absentee from school *Weight loss 117-->106 lbs *Less appetite *No headaches/visual complaints 8

9 Physical Examination DI *Energetic,well appearing *Growth normal *Tanner 4, 12 ml testes *Visual fields normal Laboratory Workup LabQuest Laboratory Workup DI Sodium T4 6.6 ug/dl TSH 4.4 IGF ng/ml IGFBP3 4.6 Cortisol 19.5 ug/dl Prolactin 36 ng/ml Glucose 86 mg/dl 9

10 Water Deprivation *12 hours: *Sodium 150 *Serum Osm 308 *Urine Osm <225 *Urine Osm 513 (+vasopressin) Gadolinium Contrast, to be or not to be? Hypothalamus Pit. Stalk Pituitary Gadolinium Contrast, to be or not to be? 10

11 Gadolinium Contrast, to be! MRI with Normal Pituitary Infundibular stalk Pituitary Normal Bright Spot 11

12 MRI with Thickened Pituitary Stalk Thickened infundibular stalk Pituitary Initial MRI of DI patient MRI Results *Loss of bright spot *Fullness of Infundibular stalk 12

13 What next? A) Follow-up...when? B) MRI: repeat it? C) Refer for biopsy? D) Obtain a bone age? DI in Children etiology (n=79) * Idiopathic 52% * Intracranial tumor 23% Germinoma 1/3 Cranio 1/3 Post-surg 1/3 * Histiocytosis 15% * Familial 6% * Post-trauma 3% * Autoimmune 1% Diagnosis of DI Based on Age at Presentation 13

14 Diagnosis of DI Based on Age at Presentation CNS Germinoma *7.8% of brain tumors in children *1/3 *2.5 years CNS Germinoma *7.8% of brain tumors in children *1/3 present with diabetes insipidus *2.5 years - median time until Dx (after DI) 14

15 Normal Bright Spot on T1 MRI in DI: Loss of hyperintensity? *Sensitivity: 94% (rest disappears in time) *Specificity: 90% except under 2 mo old Normal Pituitary Stalk *Normal Stalk 46% *Children with normal stalk: Idiopathic 52% Histiocytosis 19% Familial 14% CNS malform 11% Germinoma 3% 15

16 Pituitary Stalk Thickening *Stalk thickened 37% *Children with thick stalk: Leger Maghnie n=26 n=29 Idiopathic 65% 62% Histiocytosis 19% 17% Germinoma 15% 17% Anterior Pituitary Disease? *Some deficit 61% *Of those w/ deficiency: GH deficiency 59% Hypothyroidism 18% Hypogonadism 24% Adrenal insuffic. 22% * Prolactin > 20 30% Summary Diagnosis of Germinoma *Loss of bright spot --> not risk *Stalk thickening --> 17% risk *No thickening --> 3% risk *Progress thickening --> risk *Ant Pit Disease --> not risk *CSF Positive for hcg --> risk 16

17 Diagnosis of Germinoma What is the median time until Diagnosis? *2.5 years *1 year in the NEJM Study ==> frequent MRI indicated Conclusion DI in Children *1/3 germinoma present w/ DI *Data show under 5 yr low risk *MRI findings in DI loss of bright spot pituitary stalk thickening *PST increases risk of tumor MRI needs f/u q3-6 mo. Tanner 4 17

18 GPA 4 MRI with Ectopic Posterior Pituitary Ectopic Posterior Pituitary (EPP) *DI not common *Risk of Multiple Pituitary Hormone Disease (MPHD) *Risk of Adult GHD 18

19 Precocious Puberty *Normal *Hamartoma (neural cells, wrong location) *Mass outside of the sella Harmartoma Understanding the MRI Bright spot present? (absent in Central DI) Ectopic posterior pituitary (GHD, panhypopit, no DI) Stalk thickened? (infiltrative disorders) Optic nerve compression? Cysts or tumors? Calcifications Pineal region (germinoma) Optic nerve hypoplasia, corpus callosum 19

20 20

Laurie A. Loevner, MD

Laurie A. Loevner, MD Laurie A. Loevner, MD Chief, Division of Neuroradiology UPHS Professor of Radiology, Otorhinolaryngology: Head & Neck Surgery, Neurosurgery, and Ophthalmology University of Pennsylvania Health System Disclosures

More information

Metastasis. 57 year old with progressive Headache and Right Sided Visual Loss

Metastasis. 57 year old with progressive Headache and Right Sided Visual Loss Metastasis 1% of sellar/parasellar masses Usually occurs with known primary Can involve third ventricle, hypothalamus, infundibular stalk May be both supra-, intrasellar 57 year old with progressive Headache

More information

Endocrinological Outcome Among Treated Craniopharyngioma Patients

Endocrinological Outcome Among Treated Craniopharyngioma Patients Endocrinological Outcome Among Treated Craniopharyngioma Patients Afaf Al Sagheir, MD Head & Consultant, Section of Endocrinology/Diabetes Department of Pediatrics KFSH&RC Introduction Craniopharyngiomas

More information

PITUITARY: JUST THE BASICS PART 2 THE PATIENT

PITUITARY: JUST THE BASICS PART 2 THE PATIENT PITUITARY: JUST THE BASICS PART 2 THE PATIENT DISCLOSURE Relevant relationships with commercial entities none Potential for conflicts of interest within this presentation none Steps taken to review and

More information

Hypothalamus & Pituitary Gland

Hypothalamus & Pituitary Gland Hypothalamus & Pituitary Gland Hypothalamus and Pituitary Gland The hypothalamus and pituitary gland form a unit that exerts control over the function of several endocrine glands (thyroid, adrenals, and

More information

Imaging pituitary gland tumors

Imaging pituitary gland tumors November 2005 Imaging pituitary gland tumors Neel Varshney,, Harvard Medical School Year IV Two categories of presenting signs of a pituitary mass Functional tumors present with symptoms due to excess

More information

JACK L. SNITZER, DO INTERNAL MEDICINE BOARD REVIEW COURSE 2018 PITUITARY

JACK L. SNITZER, DO INTERNAL MEDICINE BOARD REVIEW COURSE 2018 PITUITARY JACK L. SNITZER, DO INTERNAL MEDICINE BOARD REVIEW COURSE 2018 PITUITARY JACK L. SNITZER, D.O. Peninsula Regional Endocrinology 1415 S. Division Street Salisbury, MD 21804 Phone:410-572-8848 Fax:410-572-6890

More information

Pituitary Adenomas: Evaluation and Management. Fawn M. Wolf, MD 10/27/17

Pituitary Adenomas: Evaluation and Management. Fawn M. Wolf, MD 10/27/17 Pituitary Adenomas: Evaluation and Management Fawn M. Wolf, MD 10/27/17 Over 18,000 pituitaries examined at autopsy: -10.6% contained adenomas (1.5-27%) -Frequency similar for men and women and across

More information

EXPERT DIFFERENTIAL DIAGNOSIS:

EXPERT DIFFERENTIAL DIAGNOSIS: EXPERT DIFFERENTIAL DIAGNOSIS: Sellar Region Anne G. Osborn, M.D. DISCLOSURE: Published RSNA 2008 SELLA, PITUITARY: Normal Gross, 3T Anatomy SELLA, PITUITARY: Anatomically-Based Differential Diagnoses

More information

15 month-old female with a cystic brain lesion. Magdalena Dumin, MD Pediatric Endocrinology Fellow University of Chicago December 4, 2014

15 month-old female with a cystic brain lesion. Magdalena Dumin, MD Pediatric Endocrinology Fellow University of Chicago December 4, 2014 + 15 month-old female with a cystic brain lesion Magdalena Dumin, MD Pediatric Endocrinology Fellow University of Chicago December 4, 2014 + Chief Complaint 15 month-old female admitted to PICU for concern

More information

Endocrine part two. Presented by Dr. Mohammad Saadeh The requirements for the Clinical Chemistry Philadelphia University Faculty of pharmacy

Endocrine part two. Presented by Dr. Mohammad Saadeh The requirements for the Clinical Chemistry Philadelphia University Faculty of pharmacy Endocrine part two Presented by Dr. Mohammad Saadeh The requirements for the Clinical Chemistry Philadelphia University Faculty of pharmacy Cushing's disease: increased secretion of adrenocorticotropic

More information

Case Studies in Sella/Parasellar Region. Child thirsty, increased urination. Imaging. Suprasellar Germ Cell Tumor (Germinoma) No Disclosures

Case Studies in Sella/Parasellar Region. Child thirsty, increased urination. Imaging. Suprasellar Germ Cell Tumor (Germinoma) No Disclosures Case Studies in Sella/Parasellar Region No Disclosures 2018 Head and Neck Imaging Conference Child thirsty, increased urination Suprasellar Germ Cell Tumor (Germinoma) Midline Pineal >> Suprasellar > Other

More information

See the latest estimates for new cases of pituitary tumors in the US and what research is currently being done.

See the latest estimates for new cases of pituitary tumors in the US and what research is currently being done. About Pituitary Tumors Overview and Types If you have been diagnosed with a pituitary tumor or worried about it, you likely have a lot of questions. Learning some basics is a good place to start. What

More information

Pituitary Tumors and Incidentalomas. Bijan Ahrari, MD, FACE, ECNU Palm Medical Group

Pituitary Tumors and Incidentalomas. Bijan Ahrari, MD, FACE, ECNU Palm Medical Group Pituitary Tumors and Incidentalomas Bijan Ahrari, MD, FACE, ECNU Palm Medical Group Background Pituitary incidentaloma: a previously unsuspected pituitary lesion that is discovered on an imaging study

More information

Pituitary Stalk Interruption Syndrome. Leena Shahla, MD, PGY5 Endocrinology, Diabetes and Metabolism Fellowship University of Massachusetts

Pituitary Stalk Interruption Syndrome. Leena Shahla, MD, PGY5 Endocrinology, Diabetes and Metabolism Fellowship University of Massachusetts Pituitary Stalk Interruption Syndrome Leena Shahla, MD, PGY5 Endocrinology, Diabetes and Metabolism Fellowship University of Massachusetts 11/12/2016 Case: NP, 42 year old female, from Dominican Republic.

More information

Endocrine system overview

Endocrine system overview Endocrine system overview Nature of the hormonal system -Major integrator of body function Classification of hormones Endocrine vs paracrine Nature of hormone-receptor systems Role of the hypothalamuspituitary

More information

PHARMACY POLICY STATEMENT Indiana Medicaid

PHARMACY POLICY STATEMENT Indiana Medicaid DRUG NAME BILLING CODE BENEFIT TYPE SITE OF SERVICE ALLOWED COVERAGE REQUIREMENTS LIST OF DIAGNOSES CONSIDERED NOT MEDICALLY NECESSARY PHARMACY POLICY STATEMENT Indiana Medicaid Norditropin (somatropin)

More information

PHARMACY POLICY STATEMENT Indiana Medicaid

PHARMACY POLICY STATEMENT Indiana Medicaid DRUG NAME BILLING CODE BENEFIT TYPE SITE OF SERVICE ALLOWED COVERAGE REQUIREMENTS LIST OF DIAGNOSES CONSIDERED NOT MEDICALLY NECESSARY PHARMACY POLICY STATEMENT Indiana Medicaid Zomacton (somatropin) Must

More information

Non-Functioning Tumours and Pituitary Hormone Testing. Miguel Debono Consultant in Endocrinology

Non-Functioning Tumours and Pituitary Hormone Testing. Miguel Debono Consultant in Endocrinology Non-Functioning Tumours and Pituitary Hormone Testing Miguel Debono Consultant in Endocrinology Agenda Pituitary masses Non functioning pituitary adenomas Testing pituitary function Pituitary Hormone Replacement

More information

Growth hormone therapy in a girl with Turner syndrome showing a large increase over the initially predicted ht of 4 5

Growth hormone therapy in a girl with Turner syndrome showing a large increase over the initially predicted ht of 4 5 Disorders of Growth and Puberty: How to Recognize the Normal Variants vs Patients Who Need to be Evaluated Paul Kaplowitz, M.D Pediatric Endocrinology. VCU School of Medicine Interpretation of Growth Charts

More information

Introduction to Endocrinology. Hypothalamic and Pituitary diseases Prolactinoma + Acromegaly

Introduction to Endocrinology. Hypothalamic and Pituitary diseases Prolactinoma + Acromegaly Introduction to Endocrinology. Hypothalamic and Pituitary diseases Prolactinoma + Acromegaly Dr. Peter Igaz MD PhD DSc 2nd Department of Medicine Semmelweis University Fields of Endocrinology Diseases

More information

Stelios Mantis, MD DuPage Medical Group Pediatric Endocrinology

Stelios Mantis, MD DuPage Medical Group Pediatric Endocrinology Stelios Mantis, MD DuPage Medical Group Pediatric Endocrinology 4 11 13 Initial Presentation Pt initially presented to pediatrician for school physical in fall 2012. Pt was found to be overweight (BMI:

More information

22 month old female with polyuria and polydipsia. Magdalena Dumin, MD Pediatric Endocrinology Fellow University of Chicago October 23, 2014

22 month old female with polyuria and polydipsia. Magdalena Dumin, MD Pediatric Endocrinology Fellow University of Chicago October 23, 2014 22 month old female with polyuria and polydipsia Magdalena Dumin, MD Pediatric Endocrinology Fellow University of Chicago October 23, 2014 Chief Complaint 22 month old female with history of neuroblastoma

More information

Antidiuretic Hormone

Antidiuretic Hormone 1 Antidiuretic Hormone 2 Physiology of the Posterior Pituitary The posterior pituitary gland secretes two hormones which are: oxytocin, increase uterine contractions during parturition Contraction of mammary

More information

Diseases of pituitary gland

Diseases of pituitary gland Diseases of pituitary gland A brief introduction Anterior lobe = adenohypophysis Posterior lobe = neurohypophysis The production of most pituitary hormones is controlled in large part by positively and

More information

GLMS CME- Cell Group 5 10 April Greenlane Medical Specialists Pui-Ling Chan Endocrinologist

GLMS CME- Cell Group 5 10 April Greenlane Medical Specialists Pui-Ling Chan Endocrinologist GLMS CME- Cell Group 5 10 April 2018 Greenlane Medical Specialists Pui-Ling Chan Endocrinologist Pituitary case one Mrs Z; 64F Seen ORL for tinnitus wax impaction MRI Head Pituitary microadenoma (3mm)

More information

Causes of TBI vary with age

Causes of TBI vary with age Endocrinopathies after Traumatic Brain Injury Susan R. Rose, MD Professor Cincinnati Children s Hospital Medical Center University of Cincinnati Supported by Pfizer, Inc Investigator-Initiated Research

More information

Pituitary apoplexy 台北榮總內分泌新陳代謝科主治醫師林怡君

Pituitary apoplexy 台北榮總內分泌新陳代謝科主治醫師林怡君 Pituitary apoplexy 台北榮總內分泌新陳代謝科主治醫師林怡君 Williams text book of endocrinology 11 th e Anterior pituitary hormone 10-20% of pituitary cells, increase to 40% during AP PRL releasing factors: TRH, oxytocin,

More information

PATIENT INFORMATION HYPOPITUITARISM YOUR QUESTIONS ANSWERED

PATIENT INFORMATION HYPOPITUITARISM YOUR QUESTIONS ANSWERED PATIENT INFORMATION HYPOPITUITARISM YOUR QUESTIONS ANSWERED Contents What is hypopituitarism? 1 What causes hypopituitarism? 2 What are the symptoms and signs of hypopituitarism? 4 How is hypopituitarism

More information

Human Biochemistry. Hormones

Human Biochemistry. Hormones Human Biochemistry Hormones THE ENDOCRINE SYSTEM THE ENDOCRINE SYSTEM THE ENDOCRINE SYSTEM The ENDOCRINE SYSTEM = the organ system that regulates internal environment conditions by secreting hormones into

More information

Mechanism of hyperprolactinemia

Mechanism of hyperprolactinemia Hyperprolactinemia Mechanism of hyperprolactinemia Causes of hyperprolactinemia Hormone-producing pituitary tumors Prolactinoma Acromegaly Hypothalamic/pituitary stalk lesion Tumors, cysts (craniopharyngeoma,

More information

Peri-op Pituitary / Diabetes Insipidus/ Apoplexy Dr. Stan Van Uum, MD, PhD, FRCPC

Peri-op Pituitary / Diabetes Insipidus/ Apoplexy Dr. Stan Van Uum, MD, PhD, FRCPC 10 th Annual Canadian Endocrine Update 3 rd Canadian Endocrine Review Course Peri-op Pituitary / Diabetes Insipidus/ Apoplexy Dr. Stan Van Uum, MD, PhD, FRCPC 10 th Annual Canadian Endocrine Update Dr.

More information

Laura Stewart, MD, FRCPC Clinical Associate Professor Division of Pediatric Endocrinology University of British Columbia

Laura Stewart, MD, FRCPC Clinical Associate Professor Division of Pediatric Endocrinology University of British Columbia Precocious Puberty Laura Stewart, MD, FRCPC Clinical Associate Professor Division of Pediatric Endocrinology University of British Columbia Faculty Disclosure Faculty: Laura Stewart No relationships with

More information

THE ENDOCRINE AND REPRODUCTIVE SYSTEMS

THE ENDOCRINE AND REPRODUCTIVE SYSTEMS THE ENDOCRINE AND REPRODUCTIVE SYSTEMS The focus of this week s lab will be pathology of the endocrine and reproductive systems. There are a bunch of tissues and topics that can be covered in these systems,

More information

14 Girl with Cushing s Disease: An Update. Kristen Dillard, MD Endorama October 17, 2013

14 Girl with Cushing s Disease: An Update. Kristen Dillard, MD Endorama October 17, 2013 14 Girl with Cushing s Disease: An Update Kristen Dillard, MD Endorama October 17, 2013 Initial Presentation Pt initially presented to pediatrician for school physical in fall 2012. Pt was found to be

More information

Pituitary Disorders. Eiman Ali Basheir Mob: /1/2019

Pituitary Disorders. Eiman Ali Basheir Mob: /1/2019 Pituitary Disorders Eiman Ali Basheir Mob: 0915020385 31/1/2019 Objectives By the end of this lecture the students will be able to: Understand basic Pituitary axis physiology State the common causes of

More information

An Overview of Growth Hormone Deficiency in Adults

An Overview of Growth Hormone Deficiency in Adults An Overview of Growth Hormone Deficiency in Adults Table of contents page What this booklet is about........................3 What is adult growth hormone deficiency (GHD)?......3 What is the pituitary

More information

Reproductive Health and Pituitary Disease

Reproductive Health and Pituitary Disease Reproductive Health and Pituitary Disease Janet F. McLaren, MD Assistant Professor Division of Reproductive Endocrinology and Infertility Department of Obstetrics and Gynecology jmclaren@uabmc.edu Objectives

More information

The Endocrine System. Hormone =

The Endocrine System. Hormone = The Endocrine System Hormone = Types: peptide or protein = at least 3 amino acids steroid = derived from cholesterol amine = derived from single amino acids (tryptophan, tyrosine) Peptide Hormones Synthesis/transport/half-life

More information

Pituitary gland diseases

Pituitary gland diseases Pituitary gland diseases Pituitary Gland Weight 600 mg Is located within the sella turcica Anatomically and functionally distinct anterior and posterior lobes Pituitary Development The pituitary originate

More information

THE ANTERIOR PITUITARY. Embryology cont. Embryology of the pituitary BY MISPA ZUH HS09A179. Embryology cont. THE PITUIYARY GLAND Anatomy:

THE ANTERIOR PITUITARY. Embryology cont. Embryology of the pituitary BY MISPA ZUH HS09A179. Embryology cont. THE PITUIYARY GLAND Anatomy: THE ANTERIOR PITUITARY BY MISPA ZUH HS09A179 Embryology of the pituitary The pituitary is formed early in embryonic life from the fusion of the Rathke s pouch (anterior) and the diencephalon ( posterior)

More information

ENDOCRINOLOGY COORDINATION OF PHYSIOLOGICAL PROCESSES:

ENDOCRINOLOGY COORDINATION OF PHYSIOLOGICAL PROCESSES: ENDOCRINOLOGY COORDINATION OF PHYSIOLOGICAL PROCESSES: -In a living organism there must be coordination of number of physiological activities taking place simultaneously such as: movement, respiration,

More information

Initials:.. Number of patient in the registry:... Date of visit:.. Gender (genetic): female / male

Initials:.. Number of patient in the registry:... Date of visit:.. Gender (genetic): female / male 1. Patient personal details Institute code: Physician code: Initials:.. Number of patient in the registry:... Date of visit:.. Gender (genetic): female / male 2. Changes in acromegaly-specific medical

More information

The Endocrine System PART A

The Endocrine System PART A 9 The Endocrine System PART A PowerPoint Lecture Slide Presentation by Jerry L. Cook, Sam Houston University ESSENTIALS OF HUMAN ANATOMY & PHYSIOLOGY EIGHTH EDITION ELAINE N. MARIEB The Endocrine System

More information

THICKENED PITUITARY STALK WITH CENTRAL DIABETES INSIPIDUS: REPORT OF THREE CASES

THICKENED PITUITARY STALK WITH CENTRAL DIABETES INSIPIDUS: REPORT OF THREE CASES CASE REPORTS THICKENED PITUITARY STALK WITH CENTRAL DIABETES INSIPIDUS: REPORT OF THREE CASES Keh-Chau Sheen, Ching-Chung Chang, Tien-Chun Chang, and Hon-Man Liu 1 Abstract: Diabetes insipidus of central

More information

CYSTIC PROLACTINOMA: A SURGICAL DISEASE?

CYSTIC PROLACTINOMA: A SURGICAL DISEASE? AACE Clinical Case Reports Rapid Electronic Articles in Press Rapid Electronic Articles in Press are preprinted manuscripts that have been reviewed and accepted for publication, but have yet to be edited,

More information

Original Article Pituitary imaging in 129 children with growth hormone deficiency: A spectrum of findings

Original Article Pituitary imaging in 129 children with growth hormone deficiency: A spectrum of findings Original Article Pituitary imaging in 129 children with growth hormone deficiency: A spectrum of findings Rushaid N A AlJurayyan (1), Nasir A M AlJurayyan (2), Hala G Omer (2), Sharifah D A Alissa (2),

More information

Pathology of pituitary gland. By: Shifaa Qa qa

Pathology of pituitary gland. By: Shifaa Qa qa Pathology of pituitary gland By: Shifaa Qa qa Sella turcica Adenohypophysis (80%): - epithelial cells - acidophil, basophil, chromophobe - Somatotrophs, Mammosomatotrophs, Corticotrophs, Thyrotrophs, Gonadotrophs

More information

p171 - thyroid hyperplasia https://med-vmicro.med.illinois.edu/v/475/ p34 - prostate hyperplasia https://med-vmicro.med.illinois.

p171 - thyroid hyperplasia https://med-vmicro.med.illinois.edu/v/475/ p34 - prostate hyperplasia https://med-vmicro.med.illinois. THE ENDOCRINE AND REPRODUCTIVE SYSTEMS The focus of this week s lab will be pathology of the endocrine and reproductive systems. There are a bunch of tissues and topics that can be covered in these systems,

More information

Neuroendocrine challenges following hemispherectomy

Neuroendocrine challenges following hemispherectomy Neuroendocrine challenges following hemispherectomy Philip S. Zeitler MD. PhD Professor and Head Section of Endocrinology Children s Hospital Colorado University of Colorado Anschutz Medical Campus I am

More information

Medical and Rehabilitation Innovations Neuroendocrine Screening and Hormone Replacement Therapy in Trauma Related Acquired Brain Injury

Medical and Rehabilitation Innovations Neuroendocrine Screening and Hormone Replacement Therapy in Trauma Related Acquired Brain Injury Medical and Rehabilitation Innovations Neuroendocrine Screening and Hormone Replacement Therapy in Trauma Related Acquired Brain Injury BACKGROUND Trauma related acquired brain injury (ABI) is known to

More information

Hypophysis or Pituitary Gland

Hypophysis or Pituitary Gland Hypophysis or Pituitary Gland It is also called master gland because it not only secretes hormones for physiological effects, it also controls the development and functions of other endocrine glands whereas

More information

Where Has My Vision Gone? Evaluation of Sellar Lesions. Caleb Stowell,, HMS III Gillian Lieberman, MD November 2008

Where Has My Vision Gone? Evaluation of Sellar Lesions. Caleb Stowell,, HMS III Gillian Lieberman, MD November 2008 Where Has My Vision Gone? Evaluation of Sellar Lesions Caleb Stowell,, HMS III Gillian Lieberman, MD November 2008 Objectives Present a case highlighting the clinical presentation and evaluation of a sellar

More information

PUBERTY. Preetha Krishnamoorthy. Division of Pediatric Endocrinology

PUBERTY. Preetha Krishnamoorthy. Division of Pediatric Endocrinology PUBERTY Preetha Krishnamoorthy Division of Pediatric Endocrinology Case 1 8-year-old girl referred for breast development noted by mom What do you want to know? Normal or abnormal? What if this was an

More information

Robert Wadlow and his father

Robert Wadlow and his father Robert Wadlow and his father 1 Robert Wadlow Wadlow reached 8 ft 11.1 in (2.72 m) in height and weighed 485 lb (220 kg) at his death at age 22. Born in Illinois. His great size and his continued growth

More information

Endocrine System. The Endocrine Glands

Endocrine System. The Endocrine Glands Endocrine System Working together with the nervous system, the endocrine system helps maintain homeostasis in the body. Where the nervous system uses electric signals, the endocrine system uses chemical

More information

(3) Pituitary tumours

(3) Pituitary tumours Hypopituitarism Diabetes Insipidus Pituitary tumours (2) Dr T Kemp - Endocrinology and Metabolism Unit - Steve Biko Academic Hospital (3) Pituitary tumours Pituitary microadenoma - intrasellar adenoma

More information

Pathophysiology of Pituitary Gland Disorders. PHCL 415 Hadeel Alkofide May 2010

Pathophysiology of Pituitary Gland Disorders. PHCL 415 Hadeel Alkofide May 2010 Pathophysiology of Pituitary Gland Disorders PHCL 415 Hadeel Alkofide May 2010 1 Learning Objectives Understand the physiology of pituitary gland Understand acromegaly & describe its clinical features

More information

Biology 30. Morinville Community High School. Unit 2: Endocrine System. Name:

Biology 30. Morinville Community High School. Unit 2: Endocrine System. Name: Biology 30 Morinville Community High School Unit 2: Endocrine System Name: 2 Endocrine System Unit Outline Chapter 13 text p. 434-471 Key Concept A: The endocrine system and nervous system both mediate

More information

Imaging The Turkish Saddle. Russell Goodman, HMS III Dr. Gillian Lieberman

Imaging The Turkish Saddle. Russell Goodman, HMS III Dr. Gillian Lieberman Imaging The Turkish Saddle Russell Goodman, HMS III Dr. Gillian Lieberman Learning Objectives Review the anatomy of the sellar region Discuss the differential diagnosis of sellar masses Discuss typical

More information

PITUITARY PARASELLAR LESIONS. Kim Learned, MD

PITUITARY PARASELLAR LESIONS. Kim Learned, MD PITUITARY PARASELLAR LESIONS Kim Learned, MD DIFFERENTIALS Pituitary Sella Clivus, Sphenoid Sinus Suprasellar Optic chiasm, Hypothalamus, Circle of Willis Parasellar Cavernous Sinus Case 1 17 YEAR-OLD

More information

The New England Journal of Medicine CENTRAL DIABETES INSIPIDUS IN CHILDREN AND YOUNG ADULTS. Patients

The New England Journal of Medicine CENTRAL DIABETES INSIPIDUS IN CHILDREN AND YOUNG ADULTS. Patients CENTRAL DIABETES INSIPIDUS IN CHILDREN AND YOUNG ADULTS MOHAMAD MAGHNIE, M.D., PH.D., GIANLUCA COSI, M.D., EUGENIO GENOVESE, M.D., MARIA LUISA MANCA-BITTI, M.D., AMNON COHEN, M.D., SILVIA ZECCA, M.D.,

More information

OBJECTIVES. Rebecca McEachern, MD. Puberty: Too early, Too Late or Just Right? Special Acknowledgements. Maryann Johnson M.Ed.

OBJECTIVES. Rebecca McEachern, MD. Puberty: Too early, Too Late or Just Right? Special Acknowledgements. Maryann Johnson M.Ed. 1 Puberty: Too early, Too Late or Just Right? Maryann Johnson M.Ed., BSN, RN Special Acknowledgements Rebecca McEachern, MD OBJECTIVES Illustrate basic endocrine system and hormonal pathways Define the

More information

UW MEDICINE PATIENT EDUCATION. Acromegaly Symptoms and treatments. What is acromegaly? DRAFT. What are the symptoms? How is it diagnosed?

UW MEDICINE PATIENT EDUCATION. Acromegaly Symptoms and treatments. What is acromegaly? DRAFT. What are the symptoms? How is it diagnosed? UW MEDICINE PATIENT EDUCATION Acromegaly Symptoms and treatments This handout explains a health condition called acromegaly. It describes tests that are used to diagnose the condition and gives basic instructions

More information

Pharmacy Prior Authorization Growth Hormone- Clinical Guidelines

Pharmacy Prior Authorization Growth Hormone- Clinical Guidelines Genotropin, Humatrope, Norditropin, Nutropin, Omnitrope, Saizen, Serostim, somatropin, Zorbtive, Zomacton I. Growth Hormone Deficiency in Children and Adolescents: Note: Provider must submit chart notes

More information

The Endocrine System PART A

The Endocrine System PART A 9 The Endocrine System PART A PowerPoint Lecture Slide Presentation by Jerry L. Cook, Sam Houston University ESSENTIALS OF HUMAN ANATOMY & PHYSIOLOGY EIGHTH EDITION ELAINE N. MARIEB The Endocrine System

More information

Chapter 12 Endocrine System (export).notebook. February 27, Mar 17 2:59 PM. Mar 17 3:09 PM. Mar 17 3:05 PM. Mar 17 3:03 PM.

Chapter 12 Endocrine System (export).notebook. February 27, Mar 17 2:59 PM. Mar 17 3:09 PM. Mar 17 3:05 PM. Mar 17 3:03 PM. Endocrine System Hormones Chemical messengers released directly into the bloodstream Regulate: *May have wide spread effect or only affect certain tissues ** : cells with receptors that respond to specific

More information

A Boy with Optic Glioma

A Boy with Optic Glioma Clin Pediatr Endocrinol 1994;3(Suppl 4): 169-173 Copyright(C)1994 by The Japanese Society for Pediatric Endocrinology Taisuke Okada, Sumitaka Dohno, Yousei Shimasaki, Takashi Tomoda, Makiko Koga, Kumiko

More information

Evaluation and Initial Management of Hypopituitarism

Evaluation and Initial Management of Hypopituitarism Evaluation and Initial Management of Hypopituitarism Melinda Pierce, MD,* Lisa Madison, MD* *OHSU Department of Pediatrics, Division of Pediatric Endocrinology, Portland, OR. Education Gap Signs and symptoms

More information

2. Has this plan authorized this medication in the past for this member (i.e., previous authorization is on file under this plan)?

2. Has this plan authorized this medication in the past for this member (i.e., previous authorization is on file under this plan)? Pharmacy Prior Authorization AETA BETTER HEALTH KETUCK Growth Hormone (Medicaid) This fax machine is located in a secure location as required by HIPAA regulations. Complete/review information, sign and

More information

62-year-old woman with severe headache. Celeste Thomas November 1, 2012

62-year-old woman with severe headache. Celeste Thomas November 1, 2012 62-year-old woman with severe headache Celeste Thomas November 1, 2012 History of Present Illness History of hypertension and hyperlipidemia Presented to outside hospital after awakening from sleep with

More information

Diagnosing Growth Disorders. PE Clayton School of Medical Sciences, Faculty of Biology, Medicine & Health

Diagnosing Growth Disorders. PE Clayton School of Medical Sciences, Faculty of Biology, Medicine & Health Diagnosing Growth Disorders PE Clayton School of Medical Sciences, Faculty of Biology, Medicine & Health Content Normal pattern of growth and its variation Using growth charts Interpreting auxological

More information

Endocrine System. Overview Hormones Endocrine Organs

Endocrine System. Overview Hormones Endocrine Organs Endocrine System Overview Hormones Endocrine Organs Endocrine vs. Exocrine Gland Secretes hormones sweat & saliva Ductless gland has ducts Injects tissue duct is filled Chemistry of Hormones & Physiology

More information

Endocrine System Worksheet

Endocrine System Worksheet Endocrine System Worksheet Name Section A: Endocrine vs. Nervous Systems The endocrine and nervous systems function to regulate body activities. Since both systems are involved in regulation, how does

More information

The Endocrine System. Lipid-Soluble Hormones. Bio217 Sp14 Unit 5. Bio217: Pathophysiology Class Notes Professor Linda Falkow

The Endocrine System. Lipid-Soluble Hormones. Bio217 Sp14 Unit 5. Bio217: Pathophysiology Class Notes Professor Linda Falkow Bio217: Pathophysiology Class Notes Professor Linda Falkow Mechanisms of Hormonal Regulation Unit V: Endocrine System Disorders Chapter 17 Chap. 17: Mechanisms of Hormonal Regulation Chap. 18: Alterations

More information

Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline

Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline Task Force Members Maria Fleseriu, MD Ibrahim A. Hashim, PhD Niki Karavitaki, PhD Shlomo Melmed, MD M.

More information

Endocrine Glands: Hormone-secreting organs are called endocrine glands

Endocrine Glands: Hormone-secreting organs are called endocrine glands University of Jordan Department of Physiology and Biochemistry Nursing students, Academic year 2017/2018. ******************************************************************* Ref: Principles of Anatomy

More information

Endocrine System. Overview Hormones Endocrine Organs

Endocrine System. Overview Hormones Endocrine Organs Endocrine System Overview Hormones Endocrine Organs Endocrine vs. Exocrine Gland Secretes hormones sweat & saliva Ductless gland has ducts Injects tissue duct is filled Chemistry of Hormones & Physiology

More information

PedsCases Podcast Scripts

PedsCases Podcast Scripts PedsCases Podcast Scripts This is a text version of a podcast from Pedscases.com on Puberty and Pubertal Disorders Part 2: Precocious Puberty. These podcasts are designed to give medical students an overview

More information

Leticia Hernández Dávila, MD May 26, J Clin Endocrinol Metab (2016) 101 (11):

Leticia Hernández Dávila, MD May 26, J Clin Endocrinol Metab (2016) 101 (11): Leticia Hernández Dávila, MD May 26, 2017 J Clin Endocrinol Metab (2016) 101 (11): 3888-3921. DISCLOSURES None. OBJECTIVES Understanding clinical issues related to hypopituitarism, including: Biochemical

More information

BIOM2010 (till mid sem) Endocrinology. e.g. anterior pituitary gland, thyroid, adrenal. Pineal Heart GI Female

BIOM2010 (till mid sem) Endocrinology. e.g. anterior pituitary gland, thyroid, adrenal. Pineal Heart GI Female BIOM2010 (till mid sem) Endocrinology Endocrine system Endocrine gland : a that acts by directly into the which then to other parts of the body to act on (cells, tissues, organs) : found at e.g. anterior

More information

Endocrine System. Dr. Rajaa Ali

Endocrine System. Dr. Rajaa Ali Endocrine System Dr. Rajaa Ali Structure and Function of the Pituitary Gland Anterior Lobe of the Pituitary Gland (Adenohypophysis) The anterior lobe of the pituitary gland regulates other endocrine glands.

More information

panhypopituitarism Pattawan Wongwijitsook Maharat Nakhon Ratchasima hospital 17 Nov 2013

panhypopituitarism Pattawan Wongwijitsook Maharat Nakhon Ratchasima hospital 17 Nov 2013 panhypopituitarism Pattawan Wongwijitsook Maharat Nakhon Ratchasima hospital 17 Nov 2013 PITUITARY GLAND (HYPOPHYSIS CEREBRI) The master of endocrine glands master of endocrine glands It is a small oval

More information

Lecture 03. Hyophyseal Cerebri or Pituitary Gland. By: Dr Farooq Khan PMC Date: 16 th March. 2018

Lecture 03. Hyophyseal Cerebri or Pituitary Gland. By: Dr Farooq Khan PMC Date: 16 th March. 2018 Lecture 03 Hyophyseal Cerebri or Pituitary Gland By: Dr Farooq Khan PMC Date: 16 th March. 2018 The pituitary gland Also called as Hypophyseal Cerebri. Hypo.Under. Physis..Growth Cerebri Cerebrum. Small

More information

The Endocrine System: An Overview

The Endocrine System: An Overview C H A P T E R 17 The Endocrine System The Endocrine System: An Overview A system of ductless glands Secrete messenger molecules called hormones Hormones travel to distant body cells and signal characteristic

More information

Endocrine System. Chapter 18. Introduction. How Hormones Work. How Hormones Work. The Hypothalamus & Endocrine Regulation

Endocrine System. Chapter 18. Introduction. How Hormones Work. How Hormones Work. The Hypothalamus & Endocrine Regulation Introduction Endocrine System Chapter 18 The endocrine system consists of cells, tissues, & organs that secrete into the blood Hormone an organic substance secreted by a cell that has an effect on the

More information

Pituitary Tumors: adenoma, craniopharyngioma, rathke cyst

Pituitary Tumors: adenoma, craniopharyngioma, rathke cyst Pituitary Tumors: adenoma, craniopharyngioma, rathke cyst Overview Tumors that grow from the pituitary gland can affect the whole body by interfering with normal hormone levels. They can also cause headaches

More information

CATEGORY Endocrine System Review. Provide labels for the following diagram CHAPTER 13 BLM

CATEGORY Endocrine System Review. Provide labels for the following diagram CHAPTER 13 BLM CHAPTER 13 BLM 13.1.1 CATEGORY Endocrine System Review Provide labels for the following diagram. 1. 6. 2. 7. 3. 8. 4. 9. 5. 10. CHAPTER 13 BLM 13.1.2 OVERHEAD Glands and Their Secretions Endocrine gland

More information

Homeostasis Through Chemistry. The Endocrine System Topic 6.6

Homeostasis Through Chemistry. The Endocrine System Topic 6.6 Homeostasis Through Chemistry The Endocrine System Topic 6.6 Comparing NS & ES Animals have two systems of internal communication and regulation The nervous system Response time: Fast, quick Signals: electrical

More information

Living Control Mechanisms

Living Control Mechanisms Living Control Mechanisms Dr Kate Earp MBChB MRCP Specialty Registrar Chemical Pathology & Metabolic Medicine kate.earp@sth.nhs.uk 15/10/2015 Contents Aims & objectives Homeostasis Cell communication Introduction

More information

Endocrine Glands. Endocrine glands

Endocrine Glands. Endocrine glands ENDOCRINOLOGY Endocrine Glands Endocrine glands Produce substances called hormones. Ductless glands, i.e., they release hormones directly into the bloodstream Hormones only act at their target tissue where

More information

HYPOPITUITARISM. Partial or complete loss of production of one or more of the pituitary gland hormones. Diagnosis Male & Female

HYPOPITUITARISM. Partial or complete loss of production of one or more of the pituitary gland hormones. Diagnosis Male & Female HYPOPITUITARISM Partial or complete loss of production of one or more of the pituitary gland hormones. Diagnosis Male & Female About Hypopituitarism Hypopituitarism refers to decreased secretion of pituitary

More information

CIGNA HealthCare Prior Authorization Form - Growth Hormone Medications -

CIGNA HealthCare Prior Authorization Form - Growth Hormone Medications - Pharmacy Services Phone: (800)244-6224 Fax: (800)390-9745 CIGNA HealthCare Prior Authorization Form - Growth Hormone Medications - Notice: Failure to complete this form in its entirety may result in delayed

More information

ABNORMAL PITUITARY FUNCTION

ABNORMAL PITUITARY FUNCTION Overview ABNORMAL PITUITARY FUNCTION Specialist Portfolio Seminar Katie Jones Sandwell and West Birmingham Hospitals NHS Trust Anterior pituitary overview Posterior pituitary overview Pituitary dysfunction

More information

The Endocrine System - An Overview. 32 Darcy Road, St Osyth, Clacton on Sea, Essex CO16 8QF. Registered Charity Number:

The Endocrine System - An Overview. 32 Darcy Road, St Osyth, Clacton on Sea, Essex CO16 8QF. Registered Charity Number: Last Updated: 23.04.12 Review Date: 25.05.12 Thyroid UK Source materials available on request. If you would like to confirm that this is the latest version of this document please contact: THYROID UK Registered

More information

NOTES 11.5: ENDOCRINE SYSTEM. Pages

NOTES 11.5: ENDOCRINE SYSTEM. Pages NOTES 11.5: ENDOCRINE SYSTEM Pages 1031-1042 ENDOCRINE SYSTEM Communication system that controls metabolism, growth, and development with hormones Maintains homeostasis Hormones: chemical messengers released

More information

33 year old male with a history of resected craniopharyngioma (12 years ago) presents after a seizure. Jess Hwang 9/27/12

33 year old male with a history of resected craniopharyngioma (12 years ago) presents after a seizure. Jess Hwang 9/27/12 33 year old male with a history of resected craniopharyngioma (12 years ago) presents after a seizure Jess Hwang 9/27/12 Craniopharyngioma history In 2000, at age 22, he presented with headache and blurry

More information

Craniopharyngioma. Michael Gottschalk, MD,PhD University of California San Diego Rady Children s Hospital

Craniopharyngioma. Michael Gottschalk, MD,PhD University of California San Diego Rady Children s Hospital Craniopharyngioma Michael Gottschalk, MD,PhD University of California San Diego Rady Children s Hospital Objectives Incidence Clinical Presentation Treatment Options Perioperative concerns Long-term endocrine

More information