PITUITARY GLAND

Saddam Ansari
Tbilisi State Medical University

Disorders of
Pituitary Gland

Causes of Disorder of Pituitary Gland

Mainly of 2 reasons:
Hyperactivity
Hypoactivity

Disorders of Pituitary Gland

Parts involved

Hyperactivity

Hypoactivity

Anterior Pituitary

1. Gigantism
2. Acromegaly
3. Acromegalic
gigantism
4. Cushings disease

1. Dwarfism
2. Acromicria
3. Simmonds disease

Posterior Pituitary

Syndrome of
Diabetes insipidus
inappropriate
hypersecretion of ADH
(SIADH)

Anterior and Posterior

Pituitary

Dystrophia
adiposogenitalis

Disorders of Pituitary Gland

Parts involved

Hyperactivity

Hypoactivity

Anterior Pituitary

1. Gigantism
2. Acromegaly
3. Acromegalic
gigantism
4. Cushings disease

1. Dwarfism
2. Acromicria
3. Simmonds disease

Posterior Pituitary

Syndrome of
Diabetes insipidus
inappropriate
hypersecretion of ADH
(SIADH)

Anterior and Posterior

Pituitary

Dystrophia
adiposogenitalis

Gigantism
Pituitary disorder characterized by:
Excess growth of body
Average height is approximately 7 8 feet

Continued
Causes of Gigantism
Hypersecretion of GH in childhood or in

pre adult
Tumor of acidophilic cells of Anterior

pituitary

Continued
Signs and Symptoms
Huge stature : 7 or 8 feet height
Hyperglycemia , develop glycosuria ,

pituitary diabetes mellitus

Headache due to tumor of pituitary

Continued
Visual disturbances
Gigantism ends in hypopituitarism

(burning of cells of anterior pituitary )

Disorders of Pituitary Gland

Parts involved

Hyperactivity

Hypoactivity

Anterior Pituitary

1. Gigantism
2. Acromegaly
3. Acromegalic
gigantism
4. Cushings disease

1. Dwarfism
2. Acromicria
3. Simmonds disease

Posterior Pituitary

Syndrome of
Diabetes insipidus
inappropriate
hypersecretion of ADH
(SIADH)

Anterior and Posterior

Pituitary

Dystrophia
adiposogenitalis

Acromegaly
Anterior pituitary disorder characterized by:
Enlargement, thickening, and broadening of

bones
Particularly extremities of the body

Continued
Causes of Acromegaly
Hypersecretion of GH after fusion of epiphysis with shaft

of bone
Adenomatous tumor of anterior pituitary involving the
acidophilic cells.

Continued...
Signs and symptoms
Striking features are protrusion of :
Supraorbital ridges
Broadening of nose
Thickening of lips
Thickening and wrinkles formation on forehead
Lower jaw (prognathism)
Face with these features called as acromegalic or guerilla face

Continued
Signs and symptoms
Kyphosis : enlargement of hands and feet with

bowing spine
Scalp is thickened and thrown into folds
Overgrowth of body hair
Visceral organs are enlarged

Continued
Signs and symptoms
Thyroid , parathyroid and adrenal glands shows

hyperactivity
Hyperglycemia and glucosuria
Hypertension
Headache
Visual disturbance Bitemporal hemianopia

Disorders of Pituitary Gland

Parts involved

Hyperactivity

Hypoactivity

Anterior Pituitary

1. Gigantism
2. Acromegaly
3. Acromegalic
gigantism
4. Cushings disease

1. Dwarfism
2. Acromicria
3. Simmonds disease

Posterior Pituitary

Syndrome of
Diabetes insipidus
inappropriate
hypersecretion of ADH
(SIADH)

Anterior and Posterior

Pituitary

Dystrophia
adiposogenitalis

Acromegalic Gigantism
Rare disorder
Due to hypersecretion of GH in children,before fusion of

epiphysis with the shaft of bone results in Gigantism

If hyersecretion of GH is continued after the fusion of

epiphysis the symptoms of Acromegaly also appear

Disorders of Pituitary Gland

Parts involved

Hyperactivity

Hypoactivity

Anterior Pituitary

1. Gigantism
2. Acromegaly
3. Acromegalic
gigantism
4. Cushings disease

1. Dwarfism
2. Acromicria
3. Simmonds disease

Posterior Pituitary

Syndrome of
Diabetes insipidus
inappropriate
hypersecretion of ADH
(SIADH)

Anterior and Posterior

Pituitary

Dystrophia
adiposogenitalis

Cushings Disease
Rare disease characterized by obesity

Continued
Cause
Hypersecretion of glucocorticoids mainly cortisol
Either pituitary origin or adrenal origin

Cushings
disease

Cushings
syndrome

Continued
Pituitary origin
Increased secretion of ACTH leads to hyperplasia

of adrenal cortex therefore, hypersecretion of

glucocorticoids takes place
ACTH is increased by
Tumor in pituitary cells ( basophilic cells)
Malignant tumor of nonendocrine origin like cancer of
lungs or abdominal viscera
Hypothalamic disorder causing hypersecretion of
corticotropin releasing hormone

Continued
Signs and symptoms
1. Disproportionate distribution of body fat results:
Moon face : Fat accumulation and retention of water

and salt
Torso : Fat accumulation in chest and abdomen but slim
legs and arms
Buffalo hump : Fat deposit on the back of neck and
shoulder
Pot belly : Fat accumulation in upper abdomen

Continued
2. Purple striae : Reddish purple stripes on
abdomen due to mainly three reasons:
Stretching of abdominal wall by excess subcutaneous

fat
Rupture of subdermal tissues due to stretching
Deficiency of collagen fibres due to protein depletion

Continued
3. Thinning of extremities
4. Thinning of skin and subcutaneous tissues
5. Darkening of skin on neck (aconthosis)
6. Pigmentation of skin
7. Facial redness (facial plethora)
8. Weakening of muscle

Continued
9. Facial hair growth ( Hirsutism )
10. Bone resorption leads to osteoporosis
11. Hyperglycemia due to gluconeogeneis leads adrenal
diabetes and glycosuria
12. Hypertension
13. Immunosuppression resulting in susceptibility for infection
14. Poor healing

Disorders of Pituitary Gland

Parts involved

Hyperactivity

Hypoactivity

Anterior Pituitary

1. Gigantism
2. Acromegaly
3. Acromegalic
gigantism
4. Cushings disease

1. Dwarfism
2. Acromicria
3. Simmonds disease

Posterior Pituitary

Syndrome of
Diabetes insipidus
inappropriate
hypersecretion of ADH
(SIADH)

Anterior and Posterior

Pituitary

Dystrophia
adiposogenitalis

Dwarfism
Pituitary disorder in children characterized by

stunted growth

Cause of Dwarfism
Reduction in the GH in infancy or early childhood
Occurs because of following reasons:
Deficiency of GH releasing hormone from hypothalamus
Deficiency of Somatomedin C
Atrophy of acidophilic cells in the adenohypophysis
Tumor of chromophobes : nonfunctioning tumor ,

compresses and destroys the normal cells

Panhypopituitarism

Signs and Symptoms

Stunted skeletal growth
Maximum height approximately 3 feet
Head becomes slightly larger in relation of body
Mental activity is normal without any deformity
Reproductive system is not affected due to lack of

GH but in Panhypopituitarism puberty is not

obtained due to lack of gonadotropic hormone

Types of Dwarfism
Laron dwarfism
Psychogenic dwarfism
Dwarfism in dystrophia adiposogenitalis

Laron Dwarfism
Genetical disorder
Called as GH insensitivity
Occurs due to presence of abnormal GH secretagogue

receptors in liver
GHS becomes abnormal due to mutation in genes

responsible for receptor

Doesnt depend on amount of GH secretion , hormone cant

stimulate the growth due to abnormal GHS

Psychogenic Dwarfism
Due to extreme emotional deprivation or stress
Deficiency of GH
Also called as psychosocial dwarfism or Stress

dwarfism

Dwarfism in Dystrophia adiposogenitalis

Called as Frohlich syndrome
Rare childhood disorder
Characterized by :
oObesity
oGrowth retardation
oRetarded development of genital organs
oAssociated with tumors of hypothalamus
increased appetite and decrease in
gonadotropin hormone

Disorders of Pituitary Gland

Parts involved

Hyperactivity

Hypoactivity

Anterior Pituitary

1. Gigantism
2. Acromegaly
3. Acromegalic
gigantism
4. Cushings disease

1. Dwarfism
2. Acromicria
3. Simmonds disease

Posterior Pituitary

Syndrome of
Diabetes insipidus
inappropriate
hypersecretion of ADH
(SIADH)

Anterior and Posterior

Pituitary

Dystrophia
adiposogenitalis

Acromicria
Rare disease in adults characterized by the atrophy of the

extremities of the body

Causes of Acromicria
Deficiency of GH in adults
Secretion of GH decreases in the following

conditions:
Deficiency of GH releasing hormone
Atrophy of acidophilic cells in the anterior

pituitary
Tumor of chromophobes
Panhypopituitarism

Signs and Symptoms

Atrophy and thinning of extremities ( major

symptoms )
Associated with hypothyroidism
Hyposecretion of adrenocortical hormone
Person becomes lethargic and obese
Loss of sexual function

Disorders of Pituitary Gland

Parts involved

Hyperactivity

Hypoactivity

Anterior Pituitary

1. Gigantism
2. Acromegaly
3. Acromegalic
gigantism
4. Cushings disease

1. Dwarfism
2. Acromicria
3. Simmonds disease

Posterior Pituitary

Syndrome of
Diabetes insipidus
inappropriate
hypersecretion of ADH
(SIADH)

Anterior and Posterior

Pituitary

Dystrophia
adiposogenitalis

Simmonds Disease
Rare pituitary disease
Also called as cachexia
Occurs mostly in panhypopituitarism

Signs and Symptoms

Developing senile decay
Senile decay is due to deficiency of hormone

from target glands of anterior pituitary e.g. thyroid

gland, adrenal cortex and the gonads
Loss of hair and loss of teeth
The skin on face becomes dry and wrinkled.

( most common )

Summary..
Parts involved

Hyperactivity

Hypoactivity

Anterior Pituitary

1. Gigantism
2. Acromegaly
3. Acromegalic
gigantism
4. Cushings disease

1. Dwarfism
2. Acromicria
3. Simmonds disease

Posterior Pituitary

Syndrome of
Diabetes insipidus
inappropriate
hypersecretion of ADH
(SIADH)

Anterior and Posterior

Pituitary

Dystrophia
adiposogenitalis

Disorders of Pituitary Gland

Parts involved

Hyperactivity

Hypoactivity

Anterior Pituitary

1. Gigantism
2. Acromegaly
3. Acromegalic
gigantism
4. Cushings disease

1. Dwarfism
2. Acromicria
3. Simmonds disease

Posterior Pituitary

Syndrome of
Diabetes insipidus
inappropriate
hypersecretion of ADH
(SIADH)

Anterior and Posterior

Pituitary

Dystrophia
adiposogenitalis

Syndrome of Inappropriate Hypersecretion of

Antidiuretic hormone
Disease characterized by loss of sodium through

urine due to hypersecretion of ADH

Causes
Due to cerebral tumors, lung tumors and lung

cancers because the tumor cells secrete ADH

Normal secretion of ADH makes the plasma

hypotonic
Hypotonic solution inhibits the ADH secretion and

restoration of plasma osmolarity takes place

But in SIADH ,secretion of ADH from tumor is not

inhibited by hypotonic plasma

Signs and Symptoms

1. Loss of appetite
2. Weight loss
3. Nausea and vomiting
4. Headache
5. Muscle weakness , spasm and cramps
6. Fatigue
7. Restlessness and irritability

In severe conditions patient die because of coma and

convulsions

Disorders of Pituitary Gland

Parts involved

Hyperactivity

Hypoactivity

Anterior Pituitary

1. Gigantism
2. Acromegaly
3. Acromegalic
gigantism
4. Cushings disease

1. Dwarfism
2. Acromicria
3. Simmonds disease

Posterior Pituitary

Syndrome of
Diabetes insipidus
inappropriate
hypersecretion of ADH
(SIADH)

Anterior and Posterior

Pituitary

Dystrophia
adiposogenitalis

Diabetes Insipidus
Posterior Pituitary disorder characterized by excess

excretion of water through urine

Causes
Develops due to the deficiency of ADH which occurs in the
following conditions:
1.

Lesion (injury) or degradation of supraoptic and paraventricular

nuclei of hypothalamus

2.

Lesion in hypothalamo-hypophyseal tract

3.

Atrophy of posterior pituitary

4.

Inability of renal tubules to give response to ADH hormone.

Called as Nephrogenic diabetic insipidus.

Signs and Symptoms

1.Polyuria
Excretion of large quantity of dilute urine with

increased frequency of voiding is called polyuria

Daily output is 4 to 12 liters.
Due to absence of ADH ,the epithelial cells of distal

convoluted tubule in the nephron and the collecting duct

of the kidney becomes impermeable to water

Continued
2.Polydipsia
Intake of excess water
Because of polyuria ,thirst center in hypothalamus results

in intake of large quantity of water

Continued
3.Dehydration
In some cases ,the thirst center in the hypothalamus is also
affected by the lesion
Therefore water intake decreases in these patients and, the
loss of water through urine is not compensated

Disorders of Pituitary Gland

Parts involved

Hyperactivity

Hypoactivity

Anterior Pituitary

1. Gigantism
2. Acromegaly
3. Acromegalic
gigantism
4. Cushings disease

1. Dwarfism
2. Acromicria
3. Simmonds disease

Posterior Pituitary

Syndrome of
Diabetes insipidus
inappropriate
hypersecretion of ADH
(SIADH)

Anterior and Posterior

Pituitary

Dystrophia
adiposogenitalis

Dystrophia Adiposogenitalis
Characterized by obesity and hypogonadism affecting

mainly adolescent boys

Also known as Frohlich syndrome or hypothalamic

eunuchism

Causes
Hypoactivity of both anterior and posterior pituitary
Tumor in pituitary gland and hypothalamic regions

concerned with food intake and gonadal development

Injury or atrophy of pituitary gland
Genetic inablility of hypothalamus to secrete luteinizing

hormone

Symptoms
Obesity (common feature)
Sexual infantilism (failure to develop secondary sexual

characters)
Dwarfism occurs if disease starts in growing age
Called as infantile or prepubertal type of Frohlich syndrome

(in children)
and adult type of Frohlichs syndrome (in adults)
Other features are loss of vision and diabetes