Pitutary dwarfism

Saturday, May 5, 20120 comments


Pitutary dwarfism

Made easy, Simple , simplified .
 
Etiology:
  • Congenital: agenesis, aplasia, dysplasia. Traumatic.
  • Infection: T.B., sarcoidosis.
  • Neoplastic: cranio-pharyngioma, pituitary adenoma. Iatrogenic: surgical excision, irradiation.
Clinical Picture:
  • Congenital: agenesis, aplasia, dysplasia. Traumatic.
  • Infection: T.B., sarcoidosis.
  • Neoplastic: cranio-pharyngioma, pituitary adenoma. Iatrogenic: surgical excision, irradiation.
a- At birth:
  • normal size & wt.
  • may be hypotonia, hypoglycemia.
b- During childhood:
  • Short stature.
  • Rounded head.
  • Prominent head.
  • Broad face.
  • Depressed nasal bridge.
  • Saddle small nose.
  • Undeveloped Mandible & chin.
  • Short neck.
  • Proportionate limbs with small hand & feet.
  • Underdeveloped genitalia & absent body hair.
  • Normal IQ.
c- Cases with destructive pituitary lesion:
  • Initially normal, then growth failure.
  • Multiple hormonal : - TSH – ACTH – ADH – GnTH - GH
  • Headache, vomiting, squint.
TreatmentOf the cause.
  • Recombinat human growth hormone (r HGH). S.C
  • Replacement therapy for other hormones.
Causes of delayed puberty?



a- Hypogonadotropic conditions b- Hypergondotropic conditions
1- Multiple pituitary horm. .
2- Isolated G.H. .
3- Isolated GnTH
4- Syndromes (Parder - Willi syndr).
5- Systemic dise.: Nutritional, psychologic.
6- Other endocrinal cause:
hypothyroidism. Hyperprolactinemia.
7- Polycystic ovary dise.
8- Constitutional delay in growth.
1- Ovarian and testicular dysgenesis.
2- Enzyme defect.
3- Androgen in sensitivity.
4- Gonadal toxins or radiation ttt.
5- Other miscellaneous causes.
Casues of precocious puberty?
Central:
Idiopathic true precoious pouberty.
CNS disorders ( meningitis, encephalitis ) .
CNS tumors ( Hamartoma, hypothalam. Tumor ).
Peripheral:
IM0AE5~1
Male
A- Adrenal tumors
C- Congenital adrenal hyperplasia.
L- Leyding cell testicular tumor.
T- Testotoxicosis.
IM06E5~1
Female
  • Adrenal tumors.
  • Ovarian tumors
  • Follicular cysts.
  • Exogenous estrogen.
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