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Related Concept Videos

Cushing Syndrome II: Pathophysiology01:19

Cushing Syndrome II: Pathophysiology

Cortisol production is normally governed by the hypothalamic–pituitary–adrenal (HPA) axis, which maintains hormonal balance through tightly regulated feedback mechanisms. Disruption of this regulatory system is central to the development of Cushing syndrome, whether the excess cortisol originates from external medications or internal pathology. Persistent cortisol elevation alters metabolism, immune function, and endocrine signaling, producing the characteristic clinical features of the...
Cushing Syndrome I: Introduction01:26

Cushing Syndrome I: Introduction

Cushing syndrome refers to the collection of clinical manifestations that arise when tissues are exposed to excessive amounts of cortisol or cortisol-like medications over an extended period. Cortisol, a glucocorticoid produced by the adrenal cortex, regulates metabolism, immune responses, and the body’s adaptation to stress. When its concentration remains chronically elevated, these physiological pathways become dysregulated, resulting in the characteristic features of the syndrome.Exogenous...
Major Hormones and Their Functions01:27

Major Hormones and Their Functions

Hormones, the biochemical messengers produced by endocrine glands, are pivotal in regulating bodily functions and maintaining homeostasis. Each hormone's balance is crucial; imbalances can lead to significant physiological disruptions. Major hormones include oxytocin, cortisol, epinephrine, estrogen, testosterone, thyroxine, growth hormone, insulin, and glucagon.
Oxytocin, produced in the hypothalamus and released by the pituitary gland, plays a role in social bonding, childbirth, and lactation.
Adrenal Gland Disorders01:27

Adrenal Gland Disorders

Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism II: Pathophysiology

Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...
Hyperthyroidism I: Introduction01:25

Hyperthyroidism I: Introduction

Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...

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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
07:43

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Published on: January 17, 2018

Pituitary tumours: acromegaly.

Philippe Chanson1, Sylvie Salenave, Peter Kamenicky

  • 1Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Université Paris-Sud 11, INSERM U693, Le Kremlin-Bicêtre, France. philippe.chanson@bct.aphp.fr

Best Practice & Research. Clinical Endocrinology & Metabolism
|December 1, 2009
PubMed
Summary

Acromegaly, caused by excess growth hormone (GH), leads to disfigurement and systemic issues. Effective treatments, including surgery and medication, normalize GH and insulin-like growth factor-I (IGF-I) levels, enabling a normal life expectancy.

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Area of Science:

  • Endocrinology
  • Oncology
  • Genetics

Background:

  • Acromegaly results from excessive growth hormone (GH) production, typically due to a pituitary adenoma.
  • This rare condition affects 40-130 per million individuals, causing progressive somatic disfigurement and systemic complications.
  • Prognosis is significantly influenced by rheumatologic, cardiovascular, respiratory, and metabolic consequences.

Purpose of the Study:

  • To outline the diagnostic criteria for acromegaly.
  • To describe the therapeutic strategies for managing acromegaly.
  • To emphasize the importance of normalizing GH and IGF-I levels for patient outcomes.

Main Methods:

  • Diagnosis confirmed by elevated serum GH, unsuppressible by oral glucose load, and increased insulin-like growth factor-I (IGF-I) levels.
  • Treatment involves surgical excision of the adenoma as first-line therapy.
  • Medical management includes somatostatin analogues, radiotherapy, and GH-receptor antagonists (pegvisomant) for refractory cases.

Main Results:

  • Surgical intervention aims to decompress the pituitary and normalize hormone levels.
  • Multistep therapeutic approaches achieve adequate hormonal control in most patients.
  • Successful treatment allows for a normal life expectancy.

Conclusions:

  • Acromegaly management requires a comprehensive, stepwise approach.
  • Effective control of GH and IGF-I hypersecretion is crucial for preventing long-term complications.
  • Modern therapeutic strategies significantly improve patient prognosis and quality of life.