Triiodothyronine (T3).
hypopituitarism
iodine deficiency
enzyme deficiency
Manifestations
Cretinism
Hypothyroidism that occurs during fetal development
May occur as a result of a congenital defect in thyroid
development
Severe mental retardation due to poor development of the brain
Poor overall development and growth retardation
Etiology:
maternal hypothyroidism before development of the fetal
thyroid gland,
enzyme or iodine deficiency,
maternal use of drugs that block hormone synthesis
(e.g., propylthiouracil)
Clinical findings:
mental retardation, increased weight and short stature
Myxedema
Hypothyroidism in the adult
Cold intolerance
Weight gain
Fatigue
Bradycardia
Cool, dry skin
Anorexia
Constipation
Edema of the face (swelling around the eyes), hands and
ankles;
drooping eyelids
Possible long-term complications of untreated
hypothyroidism, including
cardiac hypertrophy,
heart failure, and
myxedema coma,which presents with hypothermia,
seizures and respiratory depression
Hyperthyroidism
Increased synthesis and release of T3 and T 4
Hyperthyroidism may be
a primary condition that results from an
Toxic adenoma
Hypersecretion of TSH
Iodine-induced hyperthyroidism
Grave’s disease
Patients with Grave’s disease produce antibodies
norepinephrine.
Some testosterone
Addison’s disease
A primary condition associated with atrophy of the
adrenal glands.
The majority of cases arise from autoimmune
destruction of the adrenal glands.
Some cases may occur as a result of adrenal gland
injury as a result of infection or tumors.
Destruction of the adrenal cortex, leading to a
deficiency of glucocorticoids, mineralocorticoids, and
androgens
Etiology
Autoimmune adrenalitis
Tuberculosis
Metastatic cancer
PATHOLOGY:
Atrophic, shrunken adrenal cortex, overlying a normal medulla
Presentation
Gradual onset of weakness
Skin hyperpigmentation
Hypotension
Hypoglycemia
Loss of libido
Cushing’s disease
Etiology
Iatrogenic (exogenous corticosteroids)
Elevated ACTH
Adrenocortical adenoma
DecreasedACTH .
ElevatedACTH
No cortisol suppression with dexamethasone
Pathology:
Diffuse Adrenal Hyperplasia: 75% of cases
Manifestations
The effects of Cushing’s syndrome are primarily those of
excess
cortisol.
fat distribution.
Glucose intolerance and possible diabetes mellitus.
Tachycardia
Severe headache
Palpitations
Anxiety
Definition:
Chronic systemic disease characterized by insulin deficiency or
Diagnosis:
Fasting (overnight) venous plasma glucose concentrations of 126
mg/dL or greater
After ingestion of 75 g of glucose, a 2-hour venous plasma glucose
Epidemiology
Represents 10% of cases of diabetes
betha cells
Absolutely dependent on insulin to prevent
Etiology:
Thought to be caused by an autoimmune
Loss of ~cells
Presentation
Polydipsia, polyuria, and polyphagia
Epidemiology
Represents 90% of cases of diabetes
Risk factors:
obesity, increasing age, and genetic predisposition
Pathogenesis
Relativelyreduced insulin secretion
(hyalinization)
Presentation
Frequently asymptomatic