| 词条 | Hyperpituitarism |
| 释义 |
| name = Hyperpituitarism | synonyms = | image = Pituitary gland small.gif | caption = Pituitary gland | pronounce = | field = | symptoms = | complications = | onset = | duration = | types = | causes = From a pituitary microadenoma.[1] | risks = | diagnosis = MRI[1] | differential = | prevention = | treatment = Dopamine agonists [1] | medication = | prognosis = | frequency = | deaths = }}Hyperpituitarism is a condition due to the primary hypersecretion of pituitary hormones;[1] it typically results from a pituitary adenoma. In children with hyperpituitarism, disruption of growth regulation is rare, either because of hormone hypersecretion or because of manifestations caused by local compression of the adenoma.[2] SymptomsSymptoms caused by hormone excess and associated mass effects include: {{columns-list|colwidth=30em|
}} CauseThe cause of hyperpituitarism in most cases is due to pituitary adenomas. They usually come from the anterior lobe, are functional and secrete the hormone, GH and prolactin.[6] MechanismEvidence indicates that the mechanism of hyperpituitarism can originate from genetic disruption causing pituitary tumorigenesis, most pituitary adenomas are monoclonal, which in turn indicates their origin from an event in a single cell.[2] There are three hormones that are oversecreted resulting in the pituitary adenoma: prolactin, adrenocorticotropic hormone (ACTH), and growth hormone (GH).{{medical citation needed|date=August 2015}} Excess prolactin may result in a prolactinoma[7] Excess GH results in gigantism, the severity of gigantism depends on whether the epiphyseal plate is open.[8] The four most common types of hyperpituitarism are prolactinoma, corticotropinoma (Cushing's disease), somatotropinoma (gigantism), and thyrotropinoma .[9] DiagnosisFor the diagnosis of hyperpituitarism it depends on the cell type(s) affected, clinical manifestations of hormone excess may include, gigantism or acromegaly, which can be identified by clinical and radiographic results.[10] Cushing's disease diagnosis is done with a physical examination, laboratory tests and X rays of the pituitary glands (to locate tumors)[11] For prolactinoma, diagnosis comes in the form of the measurement of serum prolactin levels and x-ray of pituitary gland.[12] TreatmentTreatment (for hyperpituitarism) in the case of prolactinoma consists of long-term medical management. Dopamine agonists are strong suppressors of PRL secretion and establish normal gonadal function. It also inhibits tumor cell replication (in some cases causes tumor shrinkage)[13] Treatment for gigantism begins with establishing target goals for IGF-1, transsphenoidal surgery (somatostatin receptor ligands- preoperatively) and postoperative imaging assessment.[14] For Cushing's disease there is surgery to extract the tumor; after surgery, the gland may slowly start to work again, though not always.[15] See also
References1. ^{{Cite web|url = http://medical-dictionary.thefreedictionary.com/hyperpituitarism|title = Hyperpituitarism|date = 2015|accessdate =28 August 2015|website = Freedictionary.com|publisher = Farlex|last = |first = }} 2. ^1 2 3 4 {{EMedicine|article|921568|Hyperpituitarism}} 3. ^1 2 {{cite book|last1=Baumle|first1=[edited by] Lois White, Gena Duncan, Wendy|title=Medical-surgical nursing : an integrated approach|date=2013|publisher=Delmar Cengage Learning|location=Clifton Park, NY|isbn=978-1-4354-8802-1|page=595|edition=3rd|url=https://books.google.com/?id=dIMHnjf0MmoC&pg=PA595&dq=Hyperpituitarism+can+cause+double+vision#v=onepage&q=Hyperpituitarism%20can%20cause%20double%20vision&f=false|accessdate=26 August 2015}} 4. ^1 2 {{cite book|last1=Hales|first1=edited by Stuart C. Yudofsky, Robert E.|title=The American Psychiatric Publishing textbook of neuropsychiatry and behavioral neurosciences|date=2007|publisher=American Psychiatric Pub.|location=Washington, DC|isbn=978-1-58562-239-9|page=815|edition=5th|url=https://books.google.com/?id=f5BEk-6yO_4C&pg=PA814&dq=cushing's+syndrome++symptoms#v=onepage&q=cushing's%20syndrome%20%20symptoms&f=false|accessdate=26 August 2015}} 5. ^1 {{cite web|title=Prolactinoma|url=https://www.nlm.nih.gov/medlineplus/ency/article/000336.htm|website=MedlinePlus|publisher=NIH|accessdate=26 August 2015}} 6. ^{{Cite book|title = Robbins and Cotran Pathologic Basis of Disease, Professional Edition: Expert Consult - Online|url = https://books.google.com/books?id=jJllBAAAQBAJ|publisher = Elsevier Health Sciences|date = 2014-08-27|isbn = 9780323296397|first = Vinay|last = Kumar|first2 = Abul K.|last2 = Abbas|first3 = Nelson|last3 = Fausto|first4 = Jon C.|last4 = Aster}} 7. ^{{Cite web|url = http://www.niddk.nih.gov/health-information/health-topics/endocrine/prolactinoma/Pages/fact-sheet.aspx|title = Prolactinoma|date = 2014|accessdate =26 August 2015|website = NIH|publisher = NIH|last = |first = }} 8. ^{{EMedicine|article|925446|Gigantism and Acromegaly}} 9. ^{{Cite book|title = Cellular Endocrinology in Health and Disease|last = Aguirre|first = Alfredo|publisher = Elsevier|year = 2014|isbn = 978-0-12-408134-5|location = |page = 24}} 10. ^{{Cite web|url = http://www.niddk.nih.gov/health-information/health-topics/endocrine/acromegaly/Pages/fact-sheet.aspx|title = Acromegaly|date = 2014|accessdate = 28 August 2015|website = NIH|publisher = National Institute of Diabetes and Digestive, Kidney Disease|last = |first = }} 11. ^{{Cite web|title = Cushing's Syndrome|url = http://www.niddk.nih.gov/health-information/health-topics/endocrine/cushings-syndrome/Pages/fact-sheet.aspx|website = www.niddk.nih.gov|accessdate = 2015-08-25}} 12. ^{{Cite book|title = Pituitary Disorders: Diagnosis and Management|url = https://books.google.com/?id=-Tnrm_scuL8C&pg=PT388&dq=prolactinoma+diagnosis#v=onepage&q=prolactinoma%2520diagnosis&f=false|publisher = John Wiley & Sons|date = 2013-02-21|isbn = 9781118559376|first = Edward|last = Laws|first2 = Shereen|last2 = Ezzat|first3 = Sylvia|last3 = Asa|first4 = Linda|last4 = Rio}} 13. ^{{EMedicine|article|921568|Hyperpituitarism|treatment}} 14. ^{{Cite web|title = National Guideline Clearinghouse {{!}} Acromegaly: an Endocrine Society clinical practice guideline.|url = https://www.guideline.gov/content.aspx?id=49121|website = www.guideline.gov|accessdate = 2015-08-25|archive-url = https://web.archive.org/web/20150907235850/http://www.guideline.gov/content.aspx?id=49121|archive-date = 2015-09-07|dead-url = yes|df = }} 15. ^{{MedlinePlusEncyclopedia|000348|Cushing disease}} Further reading
External links{{Medical resources| DiseasesDB = | ICD10 = {{ICD10|E|22||e|20}} | ICD9 = {{ICD9|253.1}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = ped | eMedicineTopic = 1092 | MeshID = D006964 }}{{Endocrine pathology}} 1 : Pituitary disorders |
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