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Related Concept Videos

The Pituitary Gland01:17

The Pituitary Gland

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The pituitary is a small endocrine organ in the sphenoid bone under the hypothalamus. Primarily, the pituitary in adults has two distinct anatomical and functional regions— the anterior and posterior lobes. During human fetal development, a third pituitary gland region called the pars intermedia atrophies and disappears. However, some of its cells migrate and exist adjacent to the anterior pituitary in adults.
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The response to stress—be it physical or psychological, acute or chronic—involves activation of the Hypothalamic-Pituitary-Adrenal (HPA) axis. The HPA axis is part of the neuroendocrine system because it involves both neuronal and hormonal communication. Its function is to regulate homeostatic systems—metabolic, cardiovascular, and immune—providing the necessary means to respond to a stressor.
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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.
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The hypothalamus is a small yet highly complex and essential brain region that plays a crucial role in regulating various bodily functions. Anatomically, it is located at the base of the brain, just above the brainstem and below the thalamus, forming part of the limbic system.
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The small, pea-sized pituitary gland is located at the base of the brain. It is crucial in regulating various bodily functions, from growth to reproduction. The gland is divided into the anterior lobe and the posterior lobe. The secretory cell clusters in the pars distalis of the anterior pituitary lobe are controlled by hypothalamic regulators and synthesize six primary hormones.
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Induction of Experimental Autoimmune Hypophysitis in SJL Mice
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Hypothalamitis and pituitary atrophy.

Sabrina Chiloiro1, Tommaso Tartaglione2, Antonella Giampietro1

  • 1Pituitary Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

Handbook of Clinical Neurology
|July 9, 2021
PubMed
Summary
This summary is machine-generated.

Hypothalamitis, a rare hypothalamic inflammation, presents diagnostic and management challenges. Early diagnosis and multidisciplinary care, including immunosuppression and hormone replacement, are crucial for effective treatment.

Keywords:
Diabetes insipidusHypophysitisHypopituitarismHypothalamusPolydipsiaPolyuria

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Area of Science:

  • Neuroendocrinology
  • Immunology
  • Rare Diseases

Background:

  • Hypothalamitis is a rare inflammatory disorder of the hypothalamus.
  • It is classified into primary (isolated) and secondary forms, with secondary being more common.
  • Secondary hypothalamitis can arise from autoimmune diseases, infections, paraneoplastic syndromes, or immune checkpoint inhibitor therapy.

Purpose of the Study:

  • To highlight the diagnostic and management challenges of hypothalamitis.
  • To emphasize the importance of early diagnosis and a multidisciplinary approach.
  • To outline key clinical features and therapeutic strategies.

Main Methods:

  • Review of clinical presentation and diagnostic criteria for hypothalamitis.
  • Emphasis on the role of magnetic resonance imaging (MRI) in diagnosis and excluding neoplastic lesions.
  • Discussion of therapeutic strategies based on etiology, including immunosuppression and hormone replacement therapy.

Main Results:

  • Diagnosis requires high clinical suspicion and is often challenging due to rarity.
  • Key symptoms include hypopituitarism, neuropsychiatric disorders, and autonomic/metabolic dysregulation.
  • MRI is crucial for diagnosis and differentiating from tumors.

Conclusions:

  • A multidisciplinary approach is essential for early diagnosis and integrated therapy of hypothalamitis.
  • Hormonal replacement therapy is critical for patients with hypopituitarism, especially diabetes insipidus, central hypoadrenalism, and hypothyroidism.
  • Immunosuppressive treatment is the mainstay for non-infective hypothalamitis after ruling out infections.