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Disorder of endocrine system

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Disorder of endocrine system

Published in: Health & Medicine

Disorder of endocrine system

  1. 1. Disorder of Endocrine System By- Mr. ASHOK DHAKA BISHNOI Director , JINC
  2. 2. Disorder of Anterior pituitary gland
  3. 3. (Growth hormone is specifically made by the anterior pituitary gland.) Normal Level  Men: < 5 ng/mL or < 226 pmol/L  Women: < 10 ng/mL or < 452 pmol/L  Children: 0-20 ng/mL or 0-904 pmol/L  Newborns: 5-40 ng/mL or 226-1808 pmol/L  Dwarfism (Lorain’s -Levi Syndrome) It is due to hyposecretion of GH.  Gigantism – It is due to hypersecretion of GH (In children) Growth Hormone/somatotropin or somatropin:-
  4. 4.  Dwarfism (Lorain’s -Levi Syndrome) It is due to hyposecretion of GH. Etiology:-  Tumor of pituitary gland  Lack of GHRH  Autoimmune Disease  Seehan Syndrome (Necrosis of pituitary gland or infraction of pituitary gland)
  5. 5. C/F:-  Short stature (adult height that is below 4 feet 10 inches (147 cm)  Short hand  Short feet D/E:-  History & PE  Stumulation test (Arginine test) eg. Norditropin  CT or MRI scan of the head (showing pituitary tumor)
  6. 6. Management:- M/M  For adult:-Somatrem (Protropin)  For Children Somaropin (Humatrope)
  7. 7. Gigantism (giantism)– It is due to hyper- secretion of GH (In children) Etiology:-  Tumor of pituitary gland  Excessive secretion of GHRH
  8. 8. C/F:-  Large hand & feet  Protrusion of jaw  Protrusion of tongue  Deepening of voice  Protrusion of supra-orbital area  Enlarged head circumference  Clubbing like figure  Joint pain  Rough skin
  9. 9. D/E;-  History & PE  Suppression test (Glucose loading test)  CT or MRI scan of the head showing pituitary tumor Management:- M/M  Bromocriptin (Prevent to release to much growth hormone)  Octreotide (Sandostatin) –Reduce Level of GH  S/M  Hypophysectomy done by 2 approaches ◦ Adenectomy (Craniotomy) ◦ Trans-Sphenoidal Hypophysectomy Note :- Hypophysectomy may be partial or complete. If Hypophysectomy is done then patient has to take life long hormonal replacement therapy for pituitary hormones
  10. 10. ADH (Anti-diuretic hormone/vasopressin)  Normal level of ADH is 1 to 5 picograms per milliliter (pcg/mL)  Diabetes Insipidus:- Due to hypo-secretion of ADH Cause:-  Head injury.  Malignant (cancerous) or benign (non-cancerous) tumours of your brain or pituitary gland.  Kidney fail to response ADH Disorder of Posterior pituitary gland
  11. 11. Types of DI:- two types of DI- Central and nephrogenic 1. Central DI:-Is a lack of ADH production and is due to damage to the pituitary gland or hypothalamus where ADH is produced. 1. Nephrogenic DI :-Is lack of response of the kidney to the fluid-conserving action of ADH  It also can be due to diseases of the kidney (such as polycystic kidney disease), certain drugs (such as lithium)
  12. 12. C/F:-  Polyurea  Polydipsia  Sign of dehydration  Low specific gravity of urine  Hypotension  Fatigue D/E:-  check sodium and potassium salts in your blood. These can be high in diabetes insipidus
  13. 13. Management:- M/M  Chlorpromide  Carbamazipine  Vasopression tennate eg Pitression  Avoid diuretics  Low sodium diet is administered
  14. 14. Syndrome of in-appropriate ADH (SIADH) is also known as Schwartz-Bartter syndrome;- Due hypersecretion of ADH SIADH was first described in 1957 Etiology:-  Infections Meningitis, Encephalitis, brain abscess  Mass / bleed Trauma, Subarachnoid hemorrhage, subdural hematoma.  Hydrocephalus
  15. 15. C/F:-  Fluid overload  HT  Weight gain  Change in mental status  Hyponatremia  Edema  Restlessness  Confusion  Delirium
  16. 16. Management:- M/M:-  Diuretics  Demeclocycline (Declomycin) treatment of hyponatremia

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