Dr Harprit Singh
Pituitary Disorders
Learning Outcomes
Recap on the layout of the hypothalamus and pituitary gland
Describe the hormones secreted by the pituitary hormones.
Explore pathology, symptoms and treatment of pituitary disorders including:
Acromegaly
Diabetes Insipidus
Hyperprolactinemia
Hypothalamus control:
- Neural (Posterior Pituitary)
- Hormonal (Anterior Pituitary)
DISORDERS Action of GH
, Dr Harprit Singh
GROWTH HORMONE
• Single chain 191 amino acid polypeptide
• GH causes cells to grow and multiply - increases rate
at which amino acids enter cells and are built into
proteins
• Secreted by somatotropic cells under regulation of
hormones from hypothalamus
GHRH (Promotes)
Somatostatin (Inhibits)
• Acts particularly on skeletal muscle and bone
• Promotes fat catabolism (burn fats for energy)
• Accelerates rate at which glycogen (in liver) is
converted into glucose
Acromegaly
Excess production of GH from anterior pituitary
gland
Pathology:
Pituitary adenomas specific to somatotrophs
Diagnostic in adults:
If levels of GH > 0.5μg/l and elevated IGF-1 levels,
OGTT test is performed and if levels of GH is not
suppressed below 0.1g/l then acromegaly is
confirmed.
Treatment: Surgery
Medical management:
Somatostatin mimetic/SR ligand (Octreotide)
GHR antagonist (Pegvisomant)
Pituitary Disorders
Learning Outcomes
Recap on the layout of the hypothalamus and pituitary gland
Describe the hormones secreted by the pituitary hormones.
Explore pathology, symptoms and treatment of pituitary disorders including:
Acromegaly
Diabetes Insipidus
Hyperprolactinemia
Hypothalamus control:
- Neural (Posterior Pituitary)
- Hormonal (Anterior Pituitary)
DISORDERS Action of GH
, Dr Harprit Singh
GROWTH HORMONE
• Single chain 191 amino acid polypeptide
• GH causes cells to grow and multiply - increases rate
at which amino acids enter cells and are built into
proteins
• Secreted by somatotropic cells under regulation of
hormones from hypothalamus
GHRH (Promotes)
Somatostatin (Inhibits)
• Acts particularly on skeletal muscle and bone
• Promotes fat catabolism (burn fats for energy)
• Accelerates rate at which glycogen (in liver) is
converted into glucose
Acromegaly
Excess production of GH from anterior pituitary
gland
Pathology:
Pituitary adenomas specific to somatotrophs
Diagnostic in adults:
If levels of GH > 0.5μg/l and elevated IGF-1 levels,
OGTT test is performed and if levels of GH is not
suppressed below 0.1g/l then acromegaly is
confirmed.
Treatment: Surgery
Medical management:
Somatostatin mimetic/SR ligand (Octreotide)
GHR antagonist (Pegvisomant)
