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Disorder of Endocrine System
By-
Mr. ASHOK DHAKA BISHNOI
Director , JINC
Disorder of Anterior pituitary gland
(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:-
 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)
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)
Management:-
M/M
 For adult:-Somatrem (Protropin)
 For Children Somaropin (Humatrope)
Gigantism (giantism)– It is due to hyper-
secretion of GH (In children)
Etiology:-
 Tumor of pituitary gland
 Excessive secretion of GHRH
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
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
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
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)
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
Management:-
M/M
 Chlorpromide
 Carbamazipine
 Vasopression tennate eg Pitression
 Avoid diuretics
 Low sodium diet is administered
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
C/F:-
 Fluid overload
 HT
 Weight gain
 Change in mental status
 Hyponatremia
 Edema
 Restlessness
 Confusion
 Delirium
Management:-
M/M:-
 Diuretics
 Demeclocycline (Declomycin) treatment of
hyponatremia

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Disorder of endocrine system

  • 1. Disorder of Endocrine System By- Mr. ASHOK DHAKA BISHNOI Director , JINC
  • 2. Disorder of Anterior pituitary gland
  • 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.  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)
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  • 6. 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)
  • 7. Management:- M/M  For adult:-Somatrem (Protropin)  For Children Somaropin (Humatrope)
  • 8. Gigantism (giantism)– It is due to hyper- secretion of GH (In children) Etiology:-  Tumor of pituitary gland  Excessive secretion of GHRH
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  • 10. 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
  • 11. 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
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  • 13. 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
  • 14. 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)
  • 15. 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
  • 16. Management:- M/M  Chlorpromide  Carbamazipine  Vasopression tennate eg Pitression  Avoid diuretics  Low sodium diet is administered
  • 17. 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
  • 18. C/F:-  Fluid overload  HT  Weight gain  Change in mental status  Hyponatremia  Edema  Restlessness  Confusion  Delirium
  • 19. Management:- M/M:-  Diuretics  Demeclocycline (Declomycin) treatment of hyponatremia