Pituitary Gland Adrenal Gland ThyroidParathyroid Thyrotoxicosis Bone Health
Pituitary Gland Adrenal Gland Thyroid/Parathyroid Thyrotoxicosis Bone Health Skin + Heart $100 $100 $200 $200 $300 $300 $400 $400 $500 $500 1
Pituitary $200 -56 year old male with loss of libido, testosterone 40 mg/d. L, and prolactin 65 mg/d. L (Normal <20) Visual Fields
What is Bitemporal Hemianopsia?
Bitemporal Hemianopsia
MRI Pituitary 2. 8 cm Macroadenoma
“Snowman” Pituitary Macroadenoma
Etiology of Hyperprolactinemia • Physiological: coitus, exercise, lactation, pregnancy, sleep, stress, breast stimulation • Pharmacological: anesthetics, anticonvulsants, antidepressants, antihistamines (H 2), anti-hypertensives, neuropeptides, cholinergic agonists, dopamine receptor blockers, estrogens/BCP’S, dopamine synthesis inhibitor, neuroleptics/antipsychotics, opiates/opiate antagonists • Pathological • Hypothalamic-pituitary stalk damage: granulomas, infiltrations, irradiation, Rathke’s cyst, trauma, tumors (craniopharyngioma, germinoma, hypothalamic metastases, meningioma, suprasellar pituitary mass extension) • Pituitary: acromegaly, prolactinoma, macroadenoma (compressive), lymphocytic hypophysitis or parasellar mass • Systemic disorders: neurogenic chest wall trauma, surgery, herpes zoster, chronic renal failure, cirrhosis, cranial radiation, epileptic seizures, polycystic ovarian disease, pseudocyesis
Hyperprolactinemia Evaluation
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