Pituitary Disorders

Complications of Hypopituitarism

ADH GH Prolactin FSH/LH TSH ACTH

Central Growth Lactation 2 Hypogonadism 2 Hypothyroidism 2 Adrenal
DI Failure Failure Insufficiency
ADH GH Prolactin FSH/LH FSH/LH TSH ACTH
H2O
-
H2O
Reabsorbed IGF-1
T3+T4 Cortisol
Inability to and
Polydipsia Na + Short Stature
Lactate Testosterone DHEA
and
Postpartum Estrogen
Muscle Mass +
Libido Progesterone

H2O loss Menstrual Infertility

Dysfunction
Polyuria

Complications of Hyperpituitarism

GH Prolactin TSH ACTH

Acromegaly Hyperprolactinemia (M/C) 2 Hyperthyroidism Cushing’s Disease
GH Prolactin
TSH
+
ACTH
+
Galactorrhea

IGF-1 Risk of OSA + Gynecomastia Cortisol

T3+T4
and
Sweating Insulin Facial Features DHEA
Resistance and
Hands/Fingers Risk of
DM-II Get Enlarged CTS
 Pituitary Disorders
Hypopituitarism Pituitary Compression Pituitary Destruction

Sheehan
Compression Pituitary Macroadenoma (>10 mm) Syndrome

Destruction Pituitary Hormones

Pituitary
-
Apoplexy
++
GH
Somatotroph
- Vascular
++
PRL Postpartum
Lactotroph Compression
Hemorrhage
-
FSH/LH +
++
Compression
Gonadotroph of Optic Infarction
- BP DIC
TSH Chiasma ICP
++ Thyrotroph
- Bitemporal 2 Headaches Perfusion Pituitary
++
ACTH Hemianopia
Corticotroph Hormones
-

++
ADH
Post. Pit.

Hyperpituitarism Hyperfunctioning Pituitary

Anti-Dopaminergics Hypothyroidism

TRH Or NO Mass Effect

Hyperfunction D2-R TRH-R
+ Pituitary
+ + Microadenoma
GH
++ L (<10 mm)
Somatotroph A
+ C
++
PRL (Most Common) T
Lactotroph O Pituitary Hormones
T
+ R
++
TSH O
Thyrotroph
P
+ H
++ Corticotroph
ACTH
Prolactin