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Hypothalamic-pituitary function in Cushing's disease.

D Le Roith, M S Shapiro, A Gutman

    Journal of Endocrinological Investigation
    |October 1, 1979
    PubMed
    Summary
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    Cushing's disease significantly impacts anterior pituitary function, affecting growth hormone (GH) and prolactin (PRL) secretion. This study reveals multiple pituitary hormone abnormalities in patients with this condition.

    Area of Science:

    • Endocrinology
    • Neuroendocrinology
    • Pituitary Gland Physiology

    Background:

    • Cushing's disease is a complex endocrine disorder characterized by excessive cortisol production.
    • The hypothalamic-pituitary axis is crucial for regulating hormone secretion, and its dysfunction can lead to various clinical manifestations.
    • Understanding the extent of pituitary involvement in Cushing's disease is essential for comprehensive patient management.

    Purpose of the Study:

    • To comprehensively evaluate hypothalamic-pituitary function in patients diagnosed with Cushing's disease.
    • To identify specific anterior pituitary hormone secretion abnormalities associated with Cushing's disease.
    • To correlate pituitary dysfunction with the underlying pathology of Cushing's disease.

    Main Methods:

    Related Experiment Videos

  • Assessment of hypothalamic-pituitary function in seven patients with confirmed Cushing's disease.
  • Stimulation tests were performed, including insulin hypoglycemia, TRH stimulation, chlorpromazine administration, and LHRH administration.
  • Basal and stimulated levels of Growth Hormone (GH), Prolactin (PRL), Thyroid-Stimulating Hormone (TSH), Luteinizing Hormone (LH), and Follicle-Stimulating Hormone (FSH) were measured.

    • Main Results:

    • Absence of GH elevation following hypoglycemia was observed in all seven patients.
    • Abnormalities in PRL secretion included basal hyperprolactinemia in three patients and blunted responses to insulin hypoglycemia and chlorpromazine in four and six patients, respectively.
    • Impaired TSH response to TRH occurred in five patients, and low basal LH/FSH levels with attenuated or absent responses to LHRH were noted in multiple subjects.

    Conclusions:

    • Cushing's disease is associated with widespread anterior pituitary hormone secretion abnormalities.
    • The observed pituitary dysfunctions, including GH, PRL, TSH, and gonadotropin deficiencies, highlight the systemic impact of the disease.
    • These findings underscore the necessity of thorough pituitary evaluation in the management of Cushing's disease.