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ENDOCRINE SYSTEM: REVIEW OF THE PATHOPHYSIOLOGY
This document discusses several endocrine glands and their associated hormones, pathologies of overproduction and underproduction. It addresses the thyroid gland and hormones which can cause Graves' disease (overproduction) or Hashimoto's disease (underproduction). It also discusses the pancreas and diabetes mellitus caused by overproduction or underproduction of insulin. Finally, it reviews the anterior pituitary gland and disorders like acromegaly and gigantism from overproduction of growth hormone, or dwarfism from underproduction.
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ENDOCRINE SYSTEM: REVIEW OF THE PATHOPHYSIOLOGY
- 1. ENDOCRINE SYSTEM PATHOPHYSIOLOGY BY: ROMMELLUIS C. ISRAEL III
- 2. ENDOCRINE SYSTEM BY: ROMMELLUIS C. ISRAEL III 2
- 3. THYROID GLAND Hormone: Thyroxin Overactivity(Too much hormone) - Increased metabolic rate - Increased food intake but loss of weight - Hyperthyroidism (Grave’s disease) - Goiter (swollen neck, maybe bulging eyes) BY: ROMMEL LUIS C. ISRAEL III 3
- 4. HYPERTHYROIDISM (GRAVE’S DISEASE) •Other names toxic diffuse goiter or exophthalmic goiter • Hyperthyroidism (overactive thyroid) occurs when your thyroid gland produces too much of the hormone thyroxine. • This can accelerate your body's metabolism, causing unintentional weight loss and a rapid or irregular heartbeat • Grave’s disease is an autoimmune disease (i.e., when the body reacts to its own tissues as though they were foreign substances). BY: ROMMEL LUIS C. ISRAEL III 4
- 5. GOITER • Goiter isan enlargement of the thyroid gland, resulting in a prominent swelling in the front of the neck. The normal human thyroid gland weighs 10 to 20 grams (about 0.3 to 0.6 ounce), and some goitrous thyroid glands weigh as much as 1,000 grams (more than 2 pounds). • A very large goiter may cause sensations of choking and can cause difficulty in breathing and swallowing. BY: ROMMEL LUIS C. ISRAEL III 5
- 6. THYROID GLAND Hormone: Thyroxin Underactivity(Not enough hormone) - Hypothyroidism (Hashimoto’s disease) - Reduced metabolic rate - Low food intake but gain of weight - Myxedema (when onset in adults) - Cretinism (when onset in children) - Can also cause a goiter BY: ROMMEL LUIS C. ISRAEL III 6
- 7. HYPOTHYROIDISM (HASHIMOTO’S DISEASE •Other names called Hashimoto thyroiditis, chronic lymphocytic thyroiditis, chronic autoimmune thyroiditis, or Struma lymphomatous, a noninfectious form of inflammation of the thyroid gland (thyroiditis). • Hypothyroidism is an underactive thyroid gland. • Hypothyroidism is the most common of the thyroid disorders. The metabolic rate falls and normal bodily functions slow down. BY: ROMMEL LUIS C. ISRAEL III 7
- 8. DIFFERENCE BETWEEN HYPERTHYROIDISM &HYPOTHYROIDISM BY: ROMMEL LUIS C. ISRAEL III 8
- 9. MYXEDEMA • Myxedema, physiologicalreaction to lack of sufficient thyroid hormone (hypothyroidism) in the adult. It can be brought about by removal of the thyroid for any cause, by a cessation of function of the gland, or simply by glandular atrophy. • Puffiness (swelling) • Fatigue • Obesity • Dry, thickened skin • Mental impairment • Thin, brittle hair BY: ROMMEL LUIS C. ISRAEL III 9
- 10. CRETINISM • Congenital iodinedeficiency syndrome, previously known as cretinism, is a condition of severely stunted physical and mental growth owing to untreated congenital deficiency of thyroid hormone (congenital hypothyroidism) usually owing to maternal hypothyroidism. • Protuberant abdomen • Short Stature • Infertility • Neurological impairment • Constant Fatigue • Obesity BY: ROMMEL LUIS C. ISRAEL III 10
- 11. PANCREAS Hormone: Insulin Overactivity - Lowblood sugar level (Hypoglycemia) Underactivity - High blood sugar level (Hyperglycemia) - Diabetes Mellitus BY: ROMMEL LUIS C. ISRAEL III 11
- 12. HYPOGLYCEMIA BY: ROMMEL LUISC. ISRAEL III 12
- 13. HYPERGLYCEMIA BY: ROMMEL LUISC. ISRAEL III 13
- 14. DIABETES MELLITUS • DiabetesMellitus ,a disorder caused by the body’s inability to produce or respond to insulin and characterized by abnormal glucose levels in the blood. • This is a chronic disease caused by inherited and/or acquired deficiency in production of insulin by the pancreas, or by the ineffectiveness of the insulin produced. BY: ROMMEL LUIS C. ISRAEL III 14
- 15. ANTERIOR PITUITARY GLAND Hormone: GrowthHormone (Somatotropin) Overactive - Gigantism (children - very tall) - Acromegaly (adults - bones & skin thicken) Underactive - Dwarfism (very short) BY: ROMMEL LUIS C. ISRAEL III 15
- 16. GIGANTISM • Gigantism, excessive growthin stature, well beyond the average for the individual’s heredity and environmental conditions. • Tall stature may result from hereditary, dietary, or other factors. Gigantism is caused by disease or disorder in those parts of the endocrine system that regulate growth and development. BY: ROMMEL LUIS C. ISRAEL III 16
- 17. ACROMEGALY • Acromegaly, growthand metabolic disorder characterized by enlargement of the skeletal extremities. It is the result of overproduction of pituitary growth hormone (somatotropin) after maturity, caused by a tumor of the pituitary gland. • Acromegaly is often associated with the abnormal growth in stature known as pituitary gigantism. BY: ROMMEL LUIS C. ISRAEL III 17
- 18. DWARFISM • Dwarfism isshort stature that results from a genetic or medical condition. Dwarfism is generally defined as an adult height of 4 feet 10 inches (147 centimeters) or less. The average adult height among people with dwarfism is 4 feet (122 cm). Many different medical conditions cause dwarfism. In general, the disorders are divided into two broad categories: •Disproportionate dwarfism. If body size is disproportionate, some parts of the body are small, and others are of average size or above-average size. Disorders causing disproportionate dwarfism inhibit the development of bones. •Proportionate dwarfism. A body is proportionately small if all parts of the body are small to the same degree and appear to be proportioned like a body of average stature. BY: ROMMEL LUIS C. ISRAEL III 18
Editor's Notes
- #3 These are the major organs of the Endocrine System, we’ll tackle each diseases or illnesses that may affect each organ.
- #5 In Graves disease the excessive secretion of thyroid hormone is accompanied by diffuse enlargement of the thyroid gland (diffuse goitre). The thyroid gland may be slightly enlarged or several times its normal size. The increased thyroid hormone production results in the symptoms and signs of hyperthyroidism. Some patients also experience exophthalmos (protrusion of the eyes), with eyelid retraction, edema of tissues surrounding the eyes, double vision, and occasionally loss of vision, all of which are symptoms of a condition known as Graves ophthalmopathy. Patients with Graves disease produce antibodies that act on the thyroid to increase thyroid hormone production and thyroid size. These same, or closely related, antibodies may cause Graves ophthalmopathy. There is no treatment for Graves disease itself. Hyperthyroidism is treated with an antithyroid drug, radioactive iodine, or, rarely, surgical removal of the thyroid.
- #6 The entire thyroid gland may be enlarged, or there may be one or more large thyroid nodules. The function of the thyroid gland may be decreased, normal, or increased. he most common type of goitre is endemic goitre, caused by iodine deficiency. Iodine is an essential nutrient that is required for the production of thyroid hormone. When iodine intake is low, thyroid hormone production is low, and in response the pituitary gland secretes greater quantities of the hormone thyrotropin (thyroid-stimulating hormone, TSH) in an attempt to restore thyroid hormone production to normal. This excess thyrotropin stimulates not only thyroid hormone production but also thyroid growth. Endemic goitre is more common among girls than boys and among women than men. It occurs most frequently in inland or mountainous regions where the natural iodine content of the water and soil is very low. Surgical removal of the thyroid gland may be necessary if the goitre causes breathing or swallowing problems.
- #8 Hypothyroidism occurs in 1.5% to 2% of women and in 0.2% of men, and it is more common with increasing age. Up to 10% of women over the age of 65 show some signs of hypothyroidism Hypothyroidism means that the thyroid gland can't make enough thyroid hormone to keep the body running normally. People are hypothyroid if they have too little thyroid hormone in the blood. Hashimoto disease is an autoimmune disorder (i.e., the body reacts to its own tissues as though they were foreign substances). Its onset is insidious, with gradual enlargement of the thyroid gland (a condition called goitre) and a gradual decrease in thyroid hormone production. The usual findings are symmetrical rubbery enlargement of the thyroid gland, symptoms and signs of hypothyroidism, or both. The natural course of the disease often includes gradually increasing thyroid enlargement, as well as increasing thyroid deficiency. There is no treatment for Hashimoto disease itself. Hypothyroidism is treated with thyroid hormone, usually thyroxine, which may also reduce the size of a goitre, if present.
- #10 The changes come on gradually: enlarged tongue; thickened skin with underlying fluid causing puffiness, particularly in the face around the eyelids and in the hands; drowsiness; apathy; sensitivity to cold; failure to menstruate (amenorrhea) or excessive menstrual bleeding (menorrhagia); cardiac enlargement; and lowering of the basal metabolic rate. The outlook for recovery, when treatment is with dessicated thyroid, is excellent. Therapy must be maintained permanently.
- #11 Sporadic and genetic congenital iodine deficiency syndrome results from abnormal development or growth of the foetal thyroid gland. This type of congenital iodine deficiency has been almost completely eliminated in developed countries by early diagnosis by newborn screening schemes followed by lifelong treatment with thyroxine (T4). Thyroxine must be dosed as tablets only, even to newborns, as the liquid oral suspensions and compounded forms cannot be depended on for reliable dosing. In the case of dosing infants, the T4 tablets are generally crushed and mixed with breast milk, formula milk or water.
- #13 Hypoglycemia, also called low blood glucose or low blood sugar, occurs when the level of glucose in your blood drops below normal If you have diabetes, you may very well be familiar with the types of symptoms a blood glucose reading 70 milligrams per deciliter (mg/dL) or below causes. The most common symptoms of hypoglycemia include shakiness, a fast heartbeat, anxiety, and hunger. If your blood sugar gets dangerously low, you may have symptoms like confusion, vision difficulties, behavioral changes, seizures, or even loss of consciousness. Hypoglycemia can occur in those without diabetes as well. Fortunately, eating or drinking some simple carbohydrates can usually provide a quick fix—but to do that you need to be able to identify the symptoms of hypoglycemia. Medications. If a medication is the cause of your hypoglycemia, your doctor will likely suggest changing the medication or adjusting the dosage. Tumor treatment. A tumor in your pancreas is treated by surgical removal of the tumor. In some cases, partial removal of the pancreas is necessary.
- #14 Hyperglycemia means high (hyper) glucose (gly) in the blood (emia). Your body needs glucose to properly function. Your cells rely on glucose for energy. Hyperglycemia is a defining characteristic of diabetes—when the blood glucose level is too high because the body isn't properly using or doesn't make the hormone insulin. Hyperglycemia is a common complication of diabetes, but through medication, exercise, and careful meal planning, you can keep your blood glucose level from going too high—and that can help you in the long-run. Exercise: Physical activity can use excess glucose in the blood. However, if a person with severe hyperglycemia finds ketones in their urine, they should avoid exercise, as this breaks down more fats and might speed up ketoacidosis. Moderating the diet: Eating less during mealtimes and snacking less, as well as focusing on low-sugar foods, helps keep the amount of glucose at a level that the body can handle. A dietitian can help a person adapt their diet in gradual and healthful ways. Altering medications: A doctor may recommend changing the timings or types of medication and insulin a person is taking if they are not reducing blood sugar as they should.
- #15 Such a deficiency results in increased concentrations of glucose in the blood, which in turn damage many of the body's systems, in particular the blood vessels and nerves. There are two principle forms of diabetes: Type 1 diabetes (formerly known as insulin-dependent) in which the pancreas fails to produce the insulin which is essential for survival. This form develops most frequently in children and adolescents, but is being increasingly noted later in life. Type 2 diabetes (formerly named non-insulin-dependent) which results from the body's inability to respond properly to the action of insulin produced by the pancreas. Type 2 diabetes is much more common and accounts for around 90% of all diabetes cases worldwide. It occurs most frequently in adults, but is being noted increasingly in adolescents as well. Treatment: The mainstay of non-pharmacological diabetes treatment is diet and physical activity.
- #17 If the pituitary gland functions normally, producing appropriate amounts of growth hormone, while epiphyseal closure is delayed, the growth period of the bones will be prolonged. Gigantism associated with androgen deficiency is more frequent in men than in women and may be genetic. In pituitary gigantism, growth is gradual but continuous and consistent; the affected person, with bones in normal proportion, may attain a height of eight feet. Muscles may be well developed but later undergo some atrophy or weakening. The life span of pituitary giants is shorter than normal because of their greater susceptibility to infection and metabolic disorders. Treatment by surgery or irradiation of the pituitary gland curtails further growth, but stature cannot be reduced once gigantism has occurred.
- #18 The onset of acromegaly is gradual. Hands and feet become enlarged; facial features are exaggerated as the jaw lengthens and the nose and forehead grow thicker; the skin thickens; and most internal organs enlarge. Headache, excessive sweating, muscle weakness, and high blood pressure are other manifestations. Acromegaly may be treated by surgical removal of the pituitary tumour or destruction of it by X-ray irradiation or liquid nitrogen.