Insufficient secretion of growth hormone in adults

Introduction Insufficient growth hormone in adults is often not clinically detectable. The signs and symptoms of pituitary dysfunction depend on its underlying cause and the lack of certain specific pituitary hormones. On the vast majority of occasions, patients are often ill and unconscious, unable to find out that they have any abnormalities, but occasionally they may suddenly or intensely. The earliest missing is often gonadotropin, followed by growth hormone, and finally TSH and ACTH. Insufficient ADH is rare in primary pituitary disease, but it is common when the pituitary stalk and hypothalamus suffer damage.

Cause

Causes of pituitary dysfunction: primary pituitary gland damage (primary hypopituitarism), pituitary tumor, pituitary blood supply disorder (severe bleeding, thrombosis, anemia or other causes), infection or inflammatory disease, nodules Disease or amyloidosis (rare), radiation, pituitary surgery, primary immune disease affects the hypothalamus (secondary hypopituitarism), hypothalamic tumor, inflammatory disease, head trauma, surgical injury pituitary or dominance Pituitary blood vessels, nerves, and a single prolactin deficiency are rare, but this is often the cause of breast-free women's postpartum women. Xihan syndrome is rare. It is mainly due to excessive loss of blood volume during childbirth and partial necrosis of the pituitary.

an examination

Related inspection

Insulin sleep test, blood glucose, insulin hypoglycemia, GH, ACTH test

Its clinical symptoms depend on the degree of hormone deficiency in the anterior pituitary. Sometimes the symptoms may suddenly appear and become noticeable, but in most cases they gradually appear and may not be noticeable to the patient for a long time. One, several or all of the anterior pituitary hormone deficiency may occur. Premenopausal women lacking gonadotropins (luteinizing hormone and follicle stimulating hormone deficiency) can cause amenorrhea, infertility, vaginal dryness and some female sexual deterioration. In men, impotence, testicular atrophy, and decreased sperm production occur, followed by infertility and certain male sexual characteristics such as body growth and facial beard degradation.

Gonadotropin deficiency is also seen in the Kalman syndrome. Intrinsic patients often have cleft lip or palate, color blindness, and loss of smell. Adult growth hormone deficiency often has fewer or no symptoms. But in children, it can cause growth retardation and even become a dwarf. Thyroid stimulating hormone deficiency causes hypothyroidism, hypothyroidism, confusion, coldness, weight gain, constipation, and dry skin. A single corticosteroid deficiency is rare, but can lead to adrenal insufficiency, fatigue, hypotension, hypoglycemia, and lack of tolerance to stress (such as major surgery, trauma, infection, etc.).

Differential diagnosis

Total pituitary dysfunction must also be differentiated from a range of other diseases, including anorexia nervosa, chronic liver disease, and dystrophic myotonia. Clinical signs of anorexia nervosa (generally seen in women) are often diagnostic. These signs include cachexia, unusual thoughts about food and body image, and retaining their secondary sexual characteristics even though they are closed. In general, the basal levels of GH and cortisol in patients with anorexia nervosa are also prone to increase. Because hypothalamic lesions can disrupt the center of appetite control, it is not unreasonable to perform a saddle X-ray examination in a suspected patient. Men with alcoholic liver disease or hemochromatosis are often suspected of hypopituitarism as long as their testicular atrophy is associated with generalized weakness. However, in most cases, laboratory tests are used to identify the underlying primary disease and to eliminate pituitary dysfunction. Morphological evidence of extensive pituitary dysfunction is rarely seen in patients who have thought of these diseases after their autopsy. The main complaints of patients with dystrophic myotonia are progressive muscle weakness, premature baldness and cataracts, and facial signs sufficient to explain premature aging: men may have testicular atrophy. Endocrine testing can rule out hypopituitarism.

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