hyperpituitarism

What is Hyperpituitarism?

Hyperpituitarism, also known as primary hypersecretion of pituitary hormones, is a rare condition where the pituitary gland produces excessive amounts of one or more hormones [1]. This can lead to various disorders affecting growth, metabolism, and other bodily functions.

Causes of Hyperpituitarism

The primary cause of hyperpituitarism is usually a functioning/secreting pituitary adenoma (a noncancerous tumor) that produces excess hormone [5]. The symptoms of pituitary gland hyperfunction can vary depending on which hormone is produced in excess, and the possible deficiencies of other pituitary hormones should also be considered during diagnosis [12].

Symptoms and Effects

An overactive pituitary gland can cause a variety of disorders that affect growth, metabolism, and other bodily functions. The symptoms and effects of hyperpituitarism can include:

• Excessive secretion of growth hormone leading to overgrowth of tissues in the body still capable of growth (gigantism) [3]
• Overproduction of hormones affecting various bodily functions
• Disruption of growth regulation in children
• Local compression of surrounding structures due to tumor growth

Definition and Diagnosis

Hyperpituitarism is defined as an excessive secretion or production of ≥1 of the hormones produced by the pituitary gland [6][7][8]. The primary causes of hyperpituitarism are various hormone-secreting pituitary tumors. Diagnostic tests for hyperpituitarism differ depending on symptoms and medical history, and a physical exam is usually performed to determine which diagnostic tests are necessary.

References

[1] Context result 2 [3] Context result 3 [5] Context result 5 [6] Context result 6 [7] Context result 7 [8] Context result 8 [12] Context result 12

Diagnostic Tests for Hyperpituitarism

Hyperpituitarism, also known as primary hypersecretion of pituitary hormones, requires a combination of medical history evaluation, physical examination, and diagnostic tests to diagnose. The following are some common diagnostic tests used to detect hyperpituitarism:

• Blood tests: These tests measure levels of the hormones made in the pituitary gland and those made in glands that the pituitary gland regulates. Blood tests can help identify which hormone is being overproduced, allowing for targeted treatment.
  • Measuring levels of insulin-like growth factor-1 (IGF-1) and growth hormone (GH) are two common blood tests used to diagnose acromegaly, a condition caused by excessive GH production [1].
• Oral glucose suppression test: This test involves consuming 75 gm of glucose with measurement of growth hormone levels at 0, 60, and 120 minutes. It can help determine if the pituitary gland is producing too much GH.
  • The oral glucose suppression test is a useful tool for diagnosing acromegaly [4].
• Thyrotropin-releasing hormone (TRH) stimulation test: This test involves administering TRH and measuring prolactin levels. It can help diagnose conditions related to excessive prolactin production.
  • In healthy patients, intravenous TRH results in a brisk rise in serum PRL in 15-30 minutes, with peak values at least twice the baseline value [3].
• MRI or CT scans: These imaging studies can help detect pituitary tumors that may be causing hyperpituitarism. They can also evaluate for presence of pituitary gland abnormalities.
  • MRI scans are often used to locate tumors in the pituitary gland, which can cause Cushing's disease [11].
• Stimulation tests: These tests involve administering a hormone or medication and measuring the response. Stimulation tests can help diagnose conditions related to excessive hormone production.
  • Dexamethasone suppression testing is one type of stimulation test used to diagnose Cushing's syndrome [6].

References:

[1] Context 1 [3] Context 3 [4] Context 4 [6] Context 6 [11] Context 14

Medication Options for Hyperpituitarism

Hyperpituitarism, also known as overactive pituitary gland, can be treated with various medications to manage the condition and its associated symptoms.

• Dopamine agonists: These are potent suppressors of prolactin (PRL) secretion and can promptly lower serum PRL levels. They are often used in the treatment of hyperpituitarism caused by prolactinomas, a type of pituitary tumor that secretes excess prolactin hormone [4][5].
• Medications to shrink tumors: If a tumor is causing hyperpituitarism, medication may be used to shrink it. This can help reduce symptoms and improve quality of life [2].
• Hormone regulation: Medications can also be used to regulate hormone levels in the body, helping to manage symptoms associated with hyperpituitarism.

It's essential to note that treatment for hyperpituitarism depends on the underlying cause and hormones affected. A healthcare professional will evaluate individual needs and develop a personalized treatment plan [6][8].

References:

[1] Context result 2 [2] Context result 3 [4] Context result 5 [5] Context result 4 [6] Context result 6 [8] Context result 8

Differential Diagnosis of Hyperpituitarism

Hyperpituitarism, also known as primary hypersecretion of pituitary hormones, is a rare condition characterized by the excessive production of one or more hormones produced by the pituitary gland. The differential diagnosis of hyperpituitarism depends on the type of hormone involved and can be complex.

Types of Differential Diagnoses

• Hyperprolactinemia: Prolactinomas, destruction of hypothalamus, nipple stimulation, chest wall stimulation, pregnancy, and drugs such as antipsychotics are some differential diagnoses to consider for hyperprolactinemia.
• Other Hormones: For other hormones involved in hyperpituitarism, differential diagnoses may include:
  • Growth hormone: excessive skeletal proportions
  • Adrenocorticotropin (ACTH): Cushing's syndrome
  • Thyroid-stimulating hormone (TSH): hyperthyroidism
  • Follicle-stimulating hormone (FSH) and luteinizing hormone (LH): polycystic ovary syndrome (PCOS)

Causes of Hyperpituitarism

The primary causes of hyperpituitarism are various hormone-secreting pituitary tumors, including non-cancerous (benign) tumors such as adenomas. These tumors can lead to the excessive production of one or more hormones produced by the pituitary gland.

References

• [1] Hyperpituitarism is a rare disease defined by an excessive production of growth hormone by the pituitary gland most often due to a secretory non-cancerous tumor (i.e., adenoma) resulting in excessive skeletal proportions; ... Differential Diagnosis ...
• [3] The differential diagnosis of hyperprolactinemia includes prolactinomas and disorders that lead to loss of dopaminergic suppression of the pituitary lactotrophs, such as tumors of the pituitary ...
• [9] Differential diagnoses of hyperpituitarism depend on the type of hormone involved. The differentials to be considered in ...