CAJI PgY lgyy 1 A^98lq (,ra(e ' 13 ollot]0066l

F'( rlnpcrd 20 it - sT ATE 12 A

OP,A NIOPHAR)I\J GIOM A

AJep,,3'9ear-old o'
J
coMPtAlNT . rnuch )horlPr ihOn hrJ snd "o-t n 'l-. . .-
pegr
CrlrLF
JnowD onv s 19^ of P'rberty ( rr flta 3 98clrj
o)o '
''

At{AMNi,sl5 PH)SICA L EXAM iNBOSA IOBY €IAM

-groduollg hod bi\rrred virion - iooto i;ke o l0-Y6or-old c/ - 6C, thyYoid horrnone hormql
(JinCe 3 monlhs q90 ) - ,ru nxql otfji+9 - Rddrol@r gx
drn l
(weighr = r) x9 \ BMt''l''+u c
- gro,v{th becomg ilower linLP htrghr: E'.lCm J {obcre " i'lov-tl+ le(l h'ctDd t v\)n51
oge 6
= U-one q9e o€
oge I
Jirhng hergh t = lOqn
- wplqht WoJ rerhorxubly (I, - ,9 ' cric{Jh r co)clficofron in Jello
. d,d; i hove onY chrdn(dtlec'lJeJ vruor o,-oudJ
- hc crrDdrh{, turLico rvJPecred
-. uorliot0tYfig''
- no fqmrly member w/ Jnorl - o^ltrry hc4naD
ilqtu1g - Pklll\,1 lerslh =; r-m (w '' . - t orrDo o,rpJj orho
- ie:ticutnr iotumo: I rnl(+ '/ ' ieygj < 6 ng i$l Lt
c H peox ., >
" pubn, huir 6)
" lerum normd,
cof r'U Dj :
. LH r +J H G, , unrerPo$;ve

-
DTA6NOJI! crqnrotrurli,]g;omo ( @vJe|, mqliiple pituitarv
rrormone Oeticlency ond cfi & gonodolroPin dsfElenCyJ

.t
TArATtog lr, I'}3n -Phormo.o)ogicol
-J \J19;col inre rvenricln

l.
pr06NC|J)J: od bonam
-ot o9e i6 / look i i'ror rnd J

- cotch uPgONth o{ ,O cm /Yeor .4 helgh, '' bq c'n now

BiP t - Tonner Srqge 3
lnF.rm coDserti !l @ngdogt..lon
lumor
o PriDsip: o\, to Dorng, beh e {i ce D r e,
hcn.mo le{i(enae,
JUITIC€

- 0,6oL popu,oJ, .. dg,oy€Cf - P/e!enf ivg :J[reeh]rg

IOPHAR'iNC'OIV)A
Jgbgrurn .rer,0mbo r
TUThorj irtck Je(rl rd hiJIolcg,J, be*embong lerodq PUber i9
- (r qn r ophq ry n9 onr] "o 3 -t% Ogn\)sO
POdO rel,o / !vorojellclr ')qroiri' |

rc' ddlt J emu q,urDor -PmrDoriye : pen,tD0nqb

Wdo:oiioo I
toi<l J;ueo o.on menjcd;JU,qr, prech rc/l mol
ivrDu r rorqJ s-,0'h i.lo_60+h ) gitt botk ,l pertu;h;
dqn relrochioJrnotic.
EgrdoJorxoo hubungon qnioro tumor dehgOn stfUt.juf -turolire iJ,rqgerg
Pemb\.,luh doroh dqn oplrc(hiolm,drbog,
-rqp - rehqurt,rc,rive : goyo
hpe D,B,C.
I'pe
ftP€ A I, qnreri$
qnreriU Co.tnYNn 6|rlgygJegrreh At
rlcrl h9 drlcty
@.nnNnilonhq A, do(i
dori hrduo Ieho I
oruerior (erebror ofigiy iOt rergongg.r
'rrpe glevoS' runPO drJrol(g!r pOJtQrJ or
rJ)oKoli PoJierr
B : men90rOm
men9o.'0m I! elevOJ,
rlqr orrQry
bqs
rlpe c, meng-<lim,'€igwri oon drrlorosi
. ,erdoJ oriun hijfopofholoyy :
- Ad0moniroomulou3
2
k poii hq Jerirg-d,d'rtmU rc,o Pd omk
t-o tg5v,1- rrp55 t opiJ ; Qpir
g) pi Pi h bgrl opi 5 d9n
n\lOgur 99 berpq)iJode

L. tomponer' fodcrr ioryo pengop\rron,

;,ororyfl d;
Thrrd v0nJndS
I€riodr tureno embrgology y9 idN,relhpu.nq{ rerrturDOf
turnbuh dori JiJO, hurhle pouch
J;gn I s9mprorD r J oxit reporq,muor, munloh,go^gguon
DeD-glrhotoD
osit loborororium : 68, ronj Jo, Lt, psH, D .)r
lr
o
cI Jcon i pangspurqn d9o dersiDO BvIonxUh leloh I\,p0/!nlohICln xePdd Omu;
MRI -n pen ling ,, opQrqJi pehgo^gxolon i(,rnor don lPgU hron hh lr,rlmu i
^\.lolxo^tcrn rpcw
Jungon dcr o.[4wot tvli ' rebob
Mqhog€m€h, :
-Pengangkoron iu mOr Tuhsn, Aliqhmv, rnenyertoi e^gi(cav'
|\€hqr}qpUh engla\.r Pergr '
-Acdiolheropg
- rnjel(ji biomgLin LroJuor.9J
' pr09n
oJiJ j 8o,1, g-gea r{u rvi v ol rcr,e dgn bedoh I rod;osi
\rkurqn rurnO. rDeoeo,ulon )ro9(Or tpturEDJr
.83aJ,b;lo )s qD,2o"lo ( E (m )
: HoFMoNe.5 , ENOOCIIINA DDOROEBJ IN 6Ei\'€AAL-'I
! DefiniJ i ; Jjngc) rimio yqng dtbowc, dalom , Endo(h n9 hJP0runc,/on
I
<Jafah, dt' eKreJi ldn ,e,, grrjgxfjn - [errllorqn podd xetelu:or
r K'crJifiXOJi : La,Je1oby Qn peny}t/, O,/io;mmune, /
o. 3 iipe hormon o. cetl -mernrsne rcL€ptor hJ ma( . pefiorehan )
1nd,color Polypelri Bam Amirn Jleroid " U 90 nc, - cqred Jon chcrnnei
Normon belirolan Pockt
M ---4 L x5 J +
,tru bq ho n runc(rr-ncl] iorf/ I
x +
memb uho chahngl l0n
Re.ppror Cg lr-J u /€O(e
tn lrotEllubt' (etr l
prcd uui f,ur ion
i<lr\.d Oim t\ir Air Lemoi(
',
A(Jl(n AlcivqJ; Akri VoJ' ,rnJeJ[ +ex celrqlo r Endocrne hyporfi.rhorion
pr$Blr) Pto'lQtn I Plbrein t 6"PrDiern coupred re(epru tQtJdd; xrn lumot. hyPQtptotio
Jt org)J PehsikOto^ hotrnon pd roQJ,tr < .tb
rUn Jt No p*Vt rOrY n a
Dim doroh iotuld'rn |q ru, dirn .oloh +
1!ryJOxU O pocro renttttvt,o! ,Q(nld1p
puJ rnu Dlruln\s I PWJ- Peruboron naD{Ofln01 i(y)ol tlo(tYtrln
berikd fq n .i - tryprcrerporuivenBlJ : ,erjOai
dgn p)urho
Drhtein
ein Jntefoxsr rerepiof @n 6-DrOle,,n
.r-IP ,(erujo,(oD
ota{ . : gpnehl.
Pothv,rory
ttu pPOyW:,b
tecepl u, e FeKl ot.

dorrnon puypoplidq cop ----a 6 atou Pehyat tI

- DiJetrpJiKon oteb j .! - hlyart e! pot rJjuenaJJ
rol an dgn GI P q. ,glwgl,j (xqrpnQ
rtypolhqtomvJ r 7FH,Gn,?t,, G nP,t 6 fru, ei n drd )(, be/i
e,\ogehovl rDnl)ol)c)
Prtuirory * T5H, IJIJ, LH, oly.rc(in J c+h i b>finon rhQropg -.o g,v(o(orqco;d
pqnu€osdon Gl. trov
i4 ihjulln,g rucogoD, DiJojrqJi d doti [t O itbunl
.,,

-cqroJekre)r : e Aocgf dj!

cholecYJfoK'h rn
I)€DgO(h { or, .iCrggl rntr0@ll{,or Pr;:ffi#;:;:[1u;iy##il,:
deneo^ endociine -d;i[,-d --"-"
-rYn+hgJD : DNA { fi)trN A "+ rrbOrcrn ' BAcepor praein ne rihoJe
ti.oji .-, lylo, p,l vt
-. "vt pt,
ry .o tnl[qL(4[to,t
ui,o9ty iriyqLyct^i
r t
- Prcier (di 90)9, )-Jirn qn (grgn\,,p' pehgiixotqn hormon,( e itcgPror lf$vlP@- yi*x olaroroh
iecteiory) .I lerx0rtc,n d9D etei( hor;o;
- penomp;k D setr peruel( rpjr porVpeprr dg
AFrivqji ,nrro rettulor rlnojg
- nvo Ql beJOr
- cYroploJm J ed itJ, It
t N-FLU ENcrN6 FAcEm;:ffi . p\)Bw, I
r0!(Orrlor, iyf Os,ng Podcr dortrr)n t.ndoclnelott1rJ.
- 9ol9t qpPorolvJ Pilrnih$, - 6d di,ned,os; J6
- bo^iKr{ Rt! C()lOt gticr i, ncnytngey\),t,
eLepl' Or t\-vtgrr, t@^w(JdF,tolctm
- recrercry groh u)e (D b. lhrro tellu lor recepl0r omlno re
Jqftngdo. rnleJiJ plorpi n g
- drkeh lngi rrnuJo,d dsl0h ,embenJ u,(on hOrrnoI, -teC ep10t .- j-..- r memedio,
-'rG 6H. NFlhlltmslaJi
iir,,(OJCI
HOrnDnJJefoid .omptex LEtl
- Di.rg klpriran olgh : .Ul\b\rt ot) toft || oge- hemo ,opu, eJ,J ,
., . prnh ( a, da n ;,.
' Adrendl corler .o colliJo)'o)daJle'one
, orort\.,rn -o pJrruEED, prwejlefon e P€rub AfU n Loff 0rm0riOnO,
#J,fl.i;j:,,1jff #
'piq(ehro { eJ rrogQ h, p/oyeji€rong J .*:i,,,8jy,,,,,r;e'iir,,po ps,t pcrr*n
{
. reSrcJ rcJlojrerone ronnon. ro c€pior cornpg, majuk
(qmJek/es i; dr,epOJKOn JeCoIo (epOr., -
ter 9 ontung xecepo1cln JInISJI J
l(e hUt g.rj !i:{i:;;,i'ie:i,}l'\,il?l!;T#'
\q irn R rr;;;;iiri'.'
P p<) t
ifri,e.,i,rru
J o t
- S9h-rhpJD: teroJClr dorl (OeJIerol Eetiroron dengcrn Je0uen(e ONA
. (})oEjteroi.< Pregn olone - plDjpJlerone qeo{ic be b' h o n ax a
- ieJr peruekrpsi dero;d l
',ii,?:Utii'" ;;Jfi e n
J ' Nonenooo/,ng
- hvOei (ecil, bu tq.l ,rotuxripji 9 gr) 'genelic
roctoi.,
'catoplaim banyoX 6 SeCO'.O g(r/ij !,gJC,/, r,oetofiliijme don . nem peogeruh I lingqr
- i'pid dropiei pq.lyox { {oomy €iiminori hornron : otrhvbu: gafi denOoOoxhir
- m,lochondrio (lJ
' midporentO t t
- voscutoriJoJi(, 4 oegtooo -
.HJrnSn rhod,ir (UJ, metOlOl'k
j.t + ;^0( rr r, menguDoh
3 'turmon doti oJom orn'ino tnocitv€horrNn preru/J of -. dxl{ n,n nfui) ]' io:;;V:;Ui ;;it.
r.,p ern
- o;Je(re5iKo n olgh
" r€lehjorflrDrd ".
:

T] don T,r
o HQrn)un mpnghosrt(an
ercr D oJ0g I
ra ta alii i i:;i f ;eii,;6;,
ferrumbv6on
t, eer w i
,eh/o, inlerorJi dgn t€rgplO/ ys
" Adrenol mod'llo . qgrepinpphrtnS. l'trQ'lg_huouDgho,) rxirmCn
ep'nephring oqn JirerD
o HypO!ho,qmv.! . dopomine trg610r.
( ce[.sur{ote,
ritri(;re ulol ) iiif,',;3f,"AT,fi
FtlQtuO r pinpo, -o meioronin
o ' Hiforri hormon ir,i,.i5l1#,##..
eqro relfeli 1 erocglosiJ cofeedbo(l( s,lr!1 yg meng;ndiKqjkan rflb.J/.vfln
- JgniheJiJ : dori )osomomrbo{ hotmor)
'rhvroithe .o
"/ ihy. DorlDoDg, dopohring,
c0 tQcho lqm I he !@to
-tryprophqn i mQ)01on;D, 5- HT Hypotto,ornuJ mef}Jexrej;ron, e.9 TR H
- ,\ Pl. pefuexrpji i +oto
'n$Oelbejor
- rh'tochJrdriq, Ef X/(J
AntetNt Ollilltv
.tG)tO
g,ono aQ9Ij"J -,;Hliitr'; ;,:ti do d {6F' t a
- 9ol9r OppororV) pfomt nehr
- bonyok reseJory
9rq nU)eS
Jc)iogaD endoKrin
.,
'e I T)IT9
- vasku,orjsOJi(D Acl,on hormoDe Podc' ldbuh
POrhri,tOy
Pengendol oD rotreJ I horrnon
-endocdne / rere(ftrp { diiepoJxon (e - oleh Slgr:ot, d1i l,)mrer novtd,dqn
slr,l<\rlo!, rorggf orgOn
doroh { riJfernik -" rgnot mp/)gn, UXOn
- Porq(,ine + epeK podoJe,yg bgrde,(o'rqn Kecerorcn ,retrBJ;
- Aulo$inQ'o ePg( podo,rei grsOmo - k-onifor nturo, - Ot?b hgpt)thotoitvJ.
- thlroLring e drJin,er)J_ ercknyO inifoJg, pe npo ruc,n
lEkrejr bot7r,o:n'tr,en,n1kot I
- Nguro0 ine . don neu retronj
m;r1 ef mgnU/Un fur€no qdOWO AnOr, tvUr
qmob: w^t.flwtslea aioqwq ,oroi , (:th,sfo!.
-ehdo(rine < lhyrDrng r'<rnu ci ;Fxreii
- PoIqUrne i gul hormo0e ,El35,9$i""d ffi i o
- qulo(t rne j
nrtr)C c,1'de - itodrofi :
- l€UaOCii ne,. ne!,OIrO fltrligr ", oh 9t ubg j mon baleOo )gsg podo
,ufhcrt,oDtvl
,rdf, ,erqboh0i fiJ'o)ogjJ
 S!]OLOG, OF H'POIHRIAMUJ TOLOGY OF HYPOTHAI.AMVJ , of HYPoPHyS,/J
xeuro,, ub e A&t ) Jrq\D set -gra L k)enohgbphgrb
" rf)dgDoce,lu,clr ne\.,ron " KtrJ dillctlt! -a i51o dari joitngpn
Polfe/ior antenor . WO qtr7venlri(ntq( toj e 2
deAJVOto- I 9 and\Jlar 4tnJv.t\.rEit trrg\
gpnc n\rc19i
Ml@to ota, pitfier
.,
99 ,rimt tt I ' prDdul(Ji d,m jrnh .Y. 919,-qn, t O t us ve W n,
Porl JeF sfuuuni -' - -
ti
^eurohonno/fj
bonyo| Lotylocin &)h BvP) L. set: e brytqqr
dtbog, top .
--_-_-.'.|-najer@pho)q4
prcseh(e - rhomtehre,
o hengonJr9l hypo pbyl,b ,C.9ei'or
porvoc lru/ qr neu ron
'ch_tonbphobe
ix tirrlw;xon
*
Pfrlon bha)on .umo.'e)a 2 hNlntt , gg WtttO
, N& medionem)der(e, bn;n
Jp)nd cord
o
g.ra
i n y-o'i i i7
o n w re n*i
- wo)r]tr,phtl
,
J
ptgtsn ?ho,on
roolepo.iko n h eu rohormone
tnhtbttir'rg doo reteerno (dlm '##i#,";#8i,ffi?"W
dorJal rr,Ebgoqni i\mrcth (eLit ) rmmmotoin
c mengontro, t
afienor "boroph'r :WtrlXlii
epttl(1,OmuJ hyroll^OoffUj .thqlornvJ oph..o !/ F5t1c,ctn L)l,cornCorfopb
(duBo,) (venrro)
) tlolet1t) -
J
di croJor lerbeht\Jl
?frtcchiolm dan
,b urvm (bdrol

7OM., OF {YPoTHALqMuJ
'Ieflgford, ventrd, d,6n(epho,qr d,bawah rholom,Jt -'-., _. i'. '-' . NUOq hyporhatom q, hor tnon sg
rne,rnbperJt
'''etttov vrttvvrql\\tenlrotdotrJ Jrd venrrjcje.
rroor.tol) venrrot dtori J,"vehtrc.rp. . .. :j.. .,
.,':.': ; ,,., ,\'.,
,\ ' lut
dont |\Jt)g5tn9a:
fuDglin{):
'Mro,.lo,l grorD,o,Sut"dor;,returuho.,ok;..4,-;/,.\,...v...r.J.rprooprrcnucJeu.,
-;f:,?Htfffir1*orin'qrd'o,rq,.,rorbm,cneNour
.,,1r- _.-. f -n"-r?,Hustaridanwrro
'v,smrgrrrnggr
- ttYp.ot},o,o- rlirn ihoqrnvJ .\;'./ l],1;,:.-i,.
.,r I
I'
-r \JK)
- t frr,rui deru) dc)n JeLrio^
drpiJdh(crn oteh
,' -Z--EE:.- i' .*') ." ,ryil:jlli,]j
H,irjt,o,",, ,,,*, ss ii;si:,lt;;;iirol,i; --Sffi%*k)#, -paioc )utor l$Bli*n u*n6
";-)--&ltYffi:il'Wl'.;
?,o "::t:*l:
*Sl,rterio,aor.nro @t tomiho.tprm,,at,--d,
q, o)uhrvDrrar0ruJ, ..,;..-:-
3i1113{ry;6;;.;;:#;#ii;illuiu"riil,*u,. -:";:;;'
-qw\,lP.'/]%, ' ..'Ij,f
,il"i;J;;H:i;l'#13,,-,
di posrerior .ref#,iii"ilj
]",.7 ' att'"','fu1*$;l
'; -' -,- ....'..{i&
-.
i:ts: ff *" l,*,utcts,r\tnsljtbytoid
-ffi1"i#1ilfrtrf"i;i!#i,a.
c*H *regunsi

::fi,:,i:T.I,1'6liiii'i.,iiiiina,c{m,cf,oor _.,,"".,
'*,.'.i*,.,,i'al.o;;i'.irli!lif;':;T' -,"-.,....- r iw&i'' .onu . o,"r'",fiii,i
.,,",,u,,,r,u
In(Jmrnt)or, o*,o-'.
,Odj el
\:-l.. ,,o,iil,,:;I;i!iiiiit,,etso,insacto
L._p regup,
' rnt!,/U'bulurh: riMion emin;ncg * -., .,
,nrrjnd,hJbr {.
t\
9. orcrr.no
yv^JJt Utq
orcttc)ion rnrnhm
lai r
Arcuore nvcJeu)
&n othk1,
c ta tx, me t qi i d veii r-o t ^.,r

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-
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i?3ldYf;ilXj:ij ',',1,.
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'ruuirJ;ffi.po:renorrvpori-orom.Ij t ;,; l', , t,., ,l ';&:,2';?ovt)tolqy
",t5i$$ffi#;*;u:'*, t...'-"
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'",';t;;:i
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I
I
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.;
tT[il:iffim''o'tenir'titi(ti'ie'irn
tt. po,rrcrio.typ olttaraff,tJ
|i,rffi,lum 4 mpngbvbvnsxon )<e ' , II Lo pusct- pefix2no!flbnh
: . ..
'
"-tl3l.i"ial1r^ -{nreriorruproophregron
itil#ii
PrfoPnc nuOei f.Fm*.m:**
oF HyporHArisMM
- d I"HY'oroGy
- ?qthwqg: hypothqtomo-hypqphyJio,,roo.t Aeg uios; orrivrrc s hyporhawmvs dilokvl<on d. r€guroji D(rlsn don mrn\/ll
' Mu,oi dsri lrypo,hcr tonvii agi6ihlia9y., dgn Lotcl )
- me,ol.ri orcuqle don
p_ennbuun
rqr,lar 6, potreiof pitu;lsry -loogstng- rg posrgrror pit urlolv ouclei
Fd rOv? nlriq/ tcrr 'tot taDgtws - e lxat Wfot plelJr ye E. mehgqlutJuh.., trbuh
tuProoplic nvdg -
oxyluun
^ucJei
+ t tungst
onle(tDf Ptl\J,|ary {JUhv rut\.rr@ .o,
hmttb$
,c medqxvng hear lN! *livt
ADH 6J j orogj!
L____l_-_________ q ^:
CDnlrol qu ron0r4l tc netvorJj ) ,uhv tvwho altjrnvtoui
t Jystgh (AN!
Jecletory vejtde .4 re at on tenn t di
drn_rnere9 u,oJ; (onrroxJ;Jn[Dth
sno tY tnenyboStlyoh runo) oKhvtq
rflt .ur^u,o( m\rJLle don Jeffesr bebpmpe
fr l.l/9r'r$ ?it r.ttot U. dtr tnp n f. pqguros,
Cjrcsdrqn rhyihm
Jhr€ror .o nv<.reu)
hypoph*$re ot mPnerim a ,npw dort
arrery ffi,l,ffi !'#Tff ?yr#.+I,'J'J,:, lel!)o n ovt pur re iJporr,o,omrc
fl ;u.t a o' w'
copittary p1$w octr. a, frCU\rfS, ho/mon
)ntt)Ddibqbr 7,,|ll,\' u t'
t- Cr)AH , rAH , GoRH , pRH, <2H .
Mehpnrhq orvludD
dqn y'DH
J (.
J omo foj
iori , , dopo rn rne
reg.r,qj po)0 emotono, don hob;tuol "!!:3,t:W"ix::nii'ff:,f|,ii{,,:\
Pojrei or hypophyJeot ve,h La baterjoJorDo d9n JiJIern ,,rDbi,( 'li,Iifj,ffi :t?H'wizlii,r;m*
J
..*f-L0gne ...,-,
F.IMBRroLo6y
ot HJpopH yJ/s oF pclPq.t'ts t
lypophyJiJ be Gmbans dan :
,7e'-lefok diJello iurctao Ndo Jfi\enoicl
- xqntongsc,odgffn do ri J I ornode!,rn tepsl d; irone (i obo goi prl]re Oivg crqdje .), d;
depon membrone b,./(c aphory rEOq J; s bowoh hypolhcrbrnn! Ld;iKar oleh
(Rcrrhl(g'J pouch ) rniurdibutum l
- " Bent{x !epP,n; potoog. 6 t'15<n
Perhjojon drencephci/on ke bovvoh W55a Ot9 gfafit.
^oqng
o,g
t lnfund b\r)!rn ) '/t
. D,rfli(g)orerot setlUtur,t q 5er6ot
lmbiro 3 mln99.\, den gAD
rr,
sinw CaVW1S\J), W fiWng()nd urg
J e ry do n ue n Pt .r.' v e
ofqt (aN I ty
lpngqtqmr
.&
eVOg,r\OSt #':t :i'tr:ei :
P,iuirge, ,$er,gdrdrJ ng 2 loWJ I
Roihke pouch - Alrerior lobe Loderohyrybyltr )
4 WJ d;JtctriJ, gctfi inl
7umh./6 ke doriqi.xe qroh in{vndibutun err^edio
(dftophg ), pc;B t,Jberoltr
+ - PPteI,w tobe (neuruhypoprur;
Selr pgdo diDding qn,grior B€/rhxe po\rch
)
Ln NrJ her\roso,
berto/nboh bcrnyal
i4vrdjbvlv
J
' OplicdlioJrnJeriet di oto!
d:s(f oqrno Jeuqe AD onrerior
iJobrrJ c{nref iorhypgpbyJir ternodctgJtaB.
J vqjrurqriJoj j
poff iubgrol,J (-PerlvoJon j(gcil ) iumbvh ayernot carorid orterg carci aamat
di Jepqnjqng ir}{undibutum
<<Joa di hlbngpmpora) )
J Juperior hypophgJ eA drrgrg rn Fen or hv pof,iysed d r te r Y
Dindihg posferi$ Rothfe pouch menjodi ., J
Pcrrs inrernfd;o urg.,r,rpp)y moclian e mi(]F.n? dan w,)sqppls patrcr;o( don pituilary Jrotl
L
neurqJ Jrolr
,n(undibvlum mehgbojilKon Poru hervojo J
Podo m€d;an sminence reruosi mjd
J
Prirno 19 piervJ o( hgpophyjeol porta, {gJtem
,OF HYPOPTI'JII I
'"'H#:,lfr33ff" Prexvr o{ h,Po,h$eoi

Negortve {eedboCf lqr)g ,n ercavganojvJ slnq,

qron mehgurorpi./OkI6td,benlqn aeh horm J
iDrrn,r, d, uo,gdor
p,tuidry. ,nteroot iugvtar vejhs
j
Conoh ACTH p meop(err Je,l .,
t. end ;I tornronoph J9;tepla r.nou, cufii on
(a.lpr,o U^. Jip€.rEu ron Jo b9 perlrng
ci r

r I ca eQ)
.?
dh ,rEdiorr run$i eMoctine r
o. MCJ9bo(Qltv,)or
foni)ot I L -,..ab-t-fJ^o.r *rg
m-)
,
Hormoni odgDOhgpo phgjrot
I
ddD cglturofJ iore
(orruot@
.-
qr

MognOceIu,qr neuron
,
hortro^ aungo. ntur oh onD One
pcrrqvenrncu, cr donsrrpl-rr-,.
nrir-e, o;-nJp#ir",n,r
op tc/-tn , AVP / Ab t1 dir I n leJ'J d; riboro'
r. somorotroph IoqdqDb J
J oronol tfqruru-, ddrt riagnaehtlof heuton
Poslenor p$ uifory --=-D ' .l/
rrgnJferxe bodan golu . d'bdtkon
J nevros&.retorg vejlcJg
, ,[ffi*'*'il*mwu*,r- ,tir[urost JiJtemir
J
Wt'tlptxJ r}el1rt/i qxon hgpof7/t,lo{Do -
nypophybeq, rrqc,
t
._:T*|liii,Hr,i,f r?,y',;,ff ux'* IjDrIrpon di WrjcoJrrjeJ dr neryg
lurmrnq, porrgriorprlu
ory
L acrtl . p .tp! ( dpruo, poMc J
5
I
ACTH * u/J rimv,q'; grvcorod,tod dOn
J
n&porue rerr,s6., orj;
Je-r Jteroid
porcru;oJ
J
. ?-UPH + lemoh dlm irpolyjti don opioid b. Pqrvocettulqr ayftgtosiJ
v. terjll{h (bo5@hil) -i'#,:,Tl#ff
-ffd,liiffrH;"dfrfliffi:,,y*. -
i?iii?#.,#ffi
oriaonjronolil(ar d tong wrtol \ #iiii;,rff jr,",,.#;:liff 1'ootpe,,s.
Porvowliutc,r Deuroh q*-,::-'-':_"-'ly'l _

conodotrop h
I
l-
L FJH dqn I.H
t bosophil)
rJH .. pQft€mDoogon FOiIe,,Jhrhuiorl
orornorosg, Jei(rpji lntUbin ( 0
".;;-#fu;*
"'"' J
on**, rlt"J,[J'
r-ong pooqt vein
fffi,fl'H[ffi:,#*i.3i,ffif^
.,
HepoPhvr'o' Porto'vei
)
/Rl,6n,prl-----r
rperrrblogen$,J, SeXrpl; i,nh,bjh ( 02
ACTH,I;I,.u{ ,rr*
rr.'u,osjriJlen,ir "::t*:?
l[X'd:;:mr;.^:J:,?i#li**,
u*Cr*rrdl berle|I)\, 6-Iro,ein couEed
(e@ or
tAB ACT - Anqtomy, ilijlology, HiJroartlr J
or flypoihojlom\rJ t lypofi,Vs.j Aldryosi ln ro(pliu.triecond rnejsenger
uDtuk mgnge foh\r r Jlr\rr(lut don cu! Loo e
9,4 tn,o t on mi krot|(opi J hyp olhol .,
don nypophysir Pelepason hormon on er,otpifuftorg
Ititlode . oengoa ,nplhoi ptfpg,o, boroh( {/
4ncrrohy ) dcn rhdg9,4JJ Iv,,h|!lo_,
/I(SoWIH rloPMoNe F*" OD GR
," 191'o to'r:,arfi;no,diJrruej;J o,ehJerrJ.omorc
podo onrcnor htuttqyreboEl
- Jhsljroiure Krn noh"ehdccnng alvjeJ B. i', ollJtolvre xm rervJdLon enODoine
1 trcDh
ro@r
e-Cr1 t. ao nsrirlJ]ionoUh'}loldrurg t. oericie,lcy 6i-l
t6 6it yg uere&t wrorp 6rl t nnr^tot* tn hxCrr
PetDO,rit,pe r h r)btrf, A - (ongenr ! O, -t xervJ(Jlqrr Cen
; dcroh. vlo/rtv WtUhEnd t-)Ofi:tr:n-,. lofitol - A(aur.ed
G,JN
(ondl'
ii. etek Ail . Cirit I t{beDoj tertundo, uJiO }ulong -N axl,|1- mcAd
clh : xrn cruoiophqry ngiorh o
1: r Mehir)gkoltqn onobotijrr€ prDre,n
- moJ\.rx n)lo aJam omitb ke JU,tfqntloJi
t0moot, panjoDg beroi ddt\.ooda\ - InlQhJ,lrvilOr 6r, -d L.oltrn'l JghdrDrrx
-roar lohtr nof|,)o.l- peDdgt,t\.,nu
i RMr, ton,*r,)lt D,vA @O l- Oen gli( JhoI r rdr\r/g
2. Hyperbyroi dim
;, - Pehggunoo n
orcto sbg urorf.rr a:ptgto Lo rDengixvrt polo {c m)liot.k(n to(tor
penderr )ulnbvh |o.nbot, vj;o ru)o/E
\-o
rne,ombA,
r. tvEnrrEkor(Otr x^Ob\l;Jfifr terfE,t<
- p€rnbpbc,Jo n os m iemdx wbt doti
genef,k ,. Pr gcbOJocio, dr\rorfj,/m
I+ aotngon fi:liloJo Crrir : pubprloj don uJ ptutaDg Dormot, \ ih-eroxJ, ohok d9n orsr r\.o v9 rdr.
- M,ngkorxon xorne^i hormol
I ojom |Pmor mjd #;Y;#il:;Ef 9. tuJhiDgl Jyndrorrrg
'+ - --..o-.91],gt a, r/r umber energy
7 3. Mehpengo,.lJhr mei2bot.Jf€ xariohdro)
r prerDqunly ond Jrno,r Ior#;f,1i,""
6ejidtronot
\. * ruouvnQ,@
9,\roe(orncordOD
. - Mehgvrongi anoju(nyo A9e (JGA )
{
ior obest
g.ltoJc, red,rn S. Ps eudobyp(pclrqrhgroidiirn
" rY, { g'\'Koio dtm 'J6A n bqyi V9 beroioyq <rD*
dolqh(']
r -Mehg,nduxJipo\xrporVT6emprod,rxs, c Merobdijme viromjn D tvjol
Percent,e PoPUlo$ nd, )oi
rr inju),n 4 dpl tnt1:'Jpbobt,on hype/itu\rr,n Penyebob I rnf 9,(Ji intro\rrerirlg, ' -;il,';;.j;;
:1. Dictberg mel;tut
.o e n@ - jGF-tA
;l erfirs. obdiron
1i 9 rcnsr16r6r; tfrumbuhqrr
.rr.ltohg den Ierqr t pen@uno0n 6d
--o 6n@scr parsior
li r6ggn 'unng q. sgndrome of
I. Diqbelpl i^ltpiddr
- *:llP*q'trm ,rhorlrrorurg \i, vo-roprEjj |l0 a polg\Jnql
{ qepojirr Prctenwdo
II- ;H,[?X;?Hj["?1Hil;Ef,iJt,,
rur)lel5r chordrocyre .rudJ e,
oJrpqrsn ic
o ,uIh er3Jgndromel-9S ;t 0)
o Noonon 'J
JgndtoDe / Pr eudo'
Tufhet,r ryndroft (116,y.X / C. l0,rJtorure rm
n wor aoite io:m"e griii
n
hOD-end(,(,rjng
l. to n5 r iru rr on o t rol).1tcJ rurg
drord€i
'i s. Je',8'oh
matebobkon oe+,.rmuvtrn tong*vi nat a6 rl) I -o {e)a;ho auroJom
,- 6enetic IoxJtdrU,.e
* (etohrron dominon pct geo ,l {g2r., J
I 6 rvrsngls-16l6erensrqji
qdlpocgre
pr€odrpocyle mjd ' Prod er- Wl,),.ru^d/om'e
de,PJ ; Jimq,)
-.D J. Jyhdrohe of Io,JJto,{re
- (ltebro, gr gontrJ
4 ,
n.idQor ljbororejn rn
r ,' Tepperrohqnioh doo mengernDsngxon POlgppprrde pd
'15(9r)-q,3)
,rr omos crn p o re rm I - Vnrro rt,J Jgnd ro.ne
i o^ or{7ern rmr;o
. lo\rren(e -Ma()D, E)ed)-gordg ]
llomocarrinvrib
-
a Mengorur €ungfi orclx dqnjoryung
synO.DDe -{ m \rIO), (fOmOJOmr6
- 0e (lw iih - yJiedn
oon Jy n d rom e
JeK€Jr gror.\iih hormChe - lJY J9r,drofitr
$
) - 6rlFH bed,(olon 4gn Mppfq yg ber4Jong .g1t ) -Klrne{g irer Jrndrcrne
" an dgn rroteln G, pcdarorr0lc,fop - - . Jxe,ero, dyJpioJ) O .n mUrOJ; -0, ,qli l,Orure due to
lYrojne anoi i 6f -R i . pituitq4rggqnr!
eodocrrnp
*J gene q ^
e dorru:t dot t
m
i- a(lrvoji odphytqle (ycraje, CAMpC) $
6 H 0) rebe)u m epip hyliJ nrnur vp
don qktvosr prorejn(|nqje A -t. PebYoxrl [roD;J
o CeIo( d;.!eo.e f reg ?, sexvo, Precocirv
t e oho, enrpnjij
mehbo,k,(ohu g, l; momDo,,(
\' q^dfoge, /eJrF,rpn
dretrpJik(,,n J( r
P(A mem(crr(onlosi (AMP rpJpor)te " CgJic fr broiu ornr _ turnuury6i
tlsrpnI brnd,ng.prurc,in ( (p E, ) . coogejtive hetr, J lhgrqrox,cc6iJ
Jentnggq tero [tivoJ; &rure
r oohn'J dxeote
, €hronic herDq ro.logtc ahemiq
\ rriotoorg
tebih rlngg; doriJebo
J
meningx<lrt on rrqnj kriry gen 'r. 3o9; dari ibv 99 diqb€rer
-t
W " H 9p ophos pho ro m; . vfomih D
\- ifrai l.thit
?"Yqde Ptt ctroirtrlprim cotir)t
ot prlu}for] ) ,
roJrJt0nJ ricl{et bodoD don \n vah Jool
Obsrrvclive(i,eep qpnoo
t 6. Mornurt lrioo
4xhvol[ronflh6;9e, cd "'o YY]INA \- Fenyo,fil pqt, Dq Umum d6ri
aanproruJn 6HO xependetCn rib\rh J€teroh 92 a torl.b,tt )<lrory,pahjaog ,sol,Ril berpE/nrr/, )
- 6H drhqrnbdt ole,hJumotorlohd. pehyqkit nq\l )'l vrvJ,ie pon-hog rctbio podo,'wni7 O,
krmir pro,,-iji1j-d,i,"'-
-c{ le(rerogotl\J65 befuiaji ryrelql.Ji 6HJ-E V N!,h,iOrleighrO + he,9hr
raehingrdtroD Jexreji 6 rt lor hergl} ttJ fJ { rqmbu I puDr;Jen:r,kto.g{J,oDr Kqer,ker;n
Jarr'k,li ,r)vt.g )ebe '':r,:i.o'
mehoYti Perat'o t' e'iam
i:ilX!:l i. Medlcqiion
Pq -. qdu
ll lyp e, ! e, lrn Jam
-.ESIoJph.meiingko,,.dn - Elo 9ehouJ giurOcortrcoid
r5 aod..lh lyoe qnd oJoAnJg, W, Nt\q
/eJpm 6H |erhcdoP lo menurunKon pelturmbuxln benwl V,
tp medicl, poho
- Dopomrheogonbr rtn;ngxolkon - P€h99unoon Oerhy) peD,doje
p -oorpnergit ogonj.t
19,0.651 6ri u 6r { prpaddprcgn }, propt,ji
menghornbor 6d nu (lu rnoion 8 berq, r(,l, ot!,,rn ,, elra,penb
uooon@ mjh ror orrorr
Podo AJ&}OJ.. hOIDon olnogo^(O { 6l -{ JcrOIum.lOO PerXJ mernbejor, pehil bgrum
m€n)rplqrkqn 6d t u/Sra^,ihlAri I ,DembetUr, J(,]lolum betv\roInO t(errlemhon
G3 . pe.turr)hJf,on penrr
perrode
6f -! PeilumDubdr p onjarg ren;! &n ghhdt
pgrrehDongion {vnqri gonod don . o, : perlurnhjhon rejh( (,vot\rme )9mt ) Gs $ qdv,,JitP oDd Jifrpe
oknvoi; horrrDngonodoirdD;; CFJhI - L,{) mentqsiJ(r01!,m
he)qL/r hgporhoromvt . pilviJary- gonod
P'g , Pertpmbangon vd vfl]a rcJfi pnjlDg
PerrurDb'Jhon penr ( Coar dah
ottc/r.l(/idenqr.)o Pgifum ounqn romhtt o.rnr
- Pe-ftembarAnoyir rvqro lernoxin leror ' f(/n.hv 1 : ,p$tcutdr
l(m - ''' ] .. r, ,
Jerjerurrdet . volurnp { r,s
- reorodrlis,
Tqnner'J Jiooe prqruJ s
- ^emotrp\loo
tefjddi 'octolpirglr gror\,rh .' ' $.a1 - 6tevarr popilra - ronnef:. ft!,qr volt.tng i,t,_b ml L^ ,^.- -
lej
lplrri
UsrO r0v,a,hyO puberrol, B2 -+ ele@s) pqp;rO,gundutCn ielop
Phqx,A J7-1,rO
-Fdo prlct i 9',q
roh\rn Pel'ta'ry,)da*otu)> " 7qm)grj i re:r,(u,or {oiurnp 6 -,) or'Jrl
-podowqnltoj g - ,J robun 8J -o pqyudqro ;), oteo,<t tu)p.) phctrvJ 6 (h l:,s3o
ronlvr p€lnbqJoJ - Iqoner g. rgncujqrVotJ/De
PervboMn riJ;l : r)_2O,r1l j
. ?; ihek?rche + perxembaDgon D! a lctptlrl a q.eotct rnembeni\rk PDaruJ ,oun tl,s't
pctgvdara 9vndurcn (sd\E - fonngls : teJr,qrrOr vOlUrDe
> 21rj
pnetus ts qn o.too teb/h J -) ,99. o
-{ r.orure, qreotq rI)eDg,tut, L ..
Pubonbe PE
rr€noa(hg
lot'id mqJ'oro >) min6rct 'lnrvr r,gDJel\JrLrh do.;
payudoro
ovo,iu,I),ulgrvJ >> 8,, -
cotmD plll/,h &)it ,toqino .Bs -+ "l poyudoro , pt t!() p\
.d^,/ l,ub;( 6<tlr , C,, ,t16 6, n
(Phgs'o)os,ll )eucorfuo.) gonod alcrolurn, tesrit penil"1
)
MECHA NIM
AreP, t3 9.o cy'
J
imbrlro,o9y hypoPhyJ;J rdtlempurno Eidiotny. rwrui y:lo:u, tl'ltuiorv , phvJ!dagy
0f l,gpolhot2lrlu,l t {r l,uirh}1! /
J
Ado l;Jo Borh(e pqJch dr iellq iurcico
J
A[erosi eKlpreri p-culehrn cmuioh on]
J
Arvmodji p-carehin dirjtoploJrno don nucreuJ
*
AbDornio,ito! h,n, poll-ivoy d,,rOJlo tvrcicq
+
Protierosr@
J
dts e t osio

development of lurylor lnos sile (slow'9.ow)r?9)

BHP, CIlI ,PHOP
+
caJnC mq5'
J
crcnrophoryngiomo -

compre$in9 Wrc
(htoJm
comprejsir g 4nlerior
.rJhylpophgjrj .or,freJslhg hpcdhd'''tr)

J^ murlrple alirilory bormone deficieEy u\ra, inhibition o{

oPPeti'e iJ t''Jeoxe ned
hanron ceuj ochvily(9
o;O 6nnu@- - - coornoge on ocuqJe
/, { \
$ nvclevj)
i^hibit ihpu,J.frDm rsrino
J r6Pihivero ril@ t'9 J
bl,.lrred vlJion '
gyl,q etr-O ,ri,;n irr,*, r
huPerPhogic'

dlrurb difrerenl,o,,on I Juh/re dsrcroP' v

I -----|(€1,
t --.-:.- .,i\ rr€n t@
IgJfoj.rcron(L)
rono
obeJe
' bonel-growth@
- .., *P@ l,^.,
nq.Ll IBJloj,e I
o

.,r
glonrh ; rerti'rror votvm@
fffi"*, i
shon$olure
Eegr'Jbrim o{
J
Jrr{ ilerotd
Pu De rty
l,h9!rology u{ re( !e iiOn
.---*4
6H

d^iltary^. PrJbic Jmo

noirG) ho.!r@) Phollvs

Il,,ctu.--, ril I
'rllLsMU5- PllUlrRRY --iR R6€r A.x15.

Aypoiholqrnus- pituilqry - .}hyroid ari( 2. iiypoihotornvJ -P)iuilory -AdreDql

sror O

)v
6N---. J(N -.-+ PVN
-/ .t .1, c.n n
I- poriqlilst
-',onlQrio. e,rn
pjtui'qry
f p'nttry\t l
IIp|lt,r!!,tu/ lar
161
J *.rn
,,4---\.-- Or*i
16-"81" \: edr9661g1ond

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