|Acromegaly/gigantism||Etiology: Gigantism and acromegaly are usually caused by a pituitary adenoma that secretes excessive amounts of Growth Hormone; rarely, they are caused by non-pituitary tumors that secrete GHRH
Treatment: Pituitary tumor removal
|Diabetes insipidus (ReelDx)||Diabetes insipidus (DI) is caused by a deficiency of or resistance to vasopressin (ADH), which decreases the kidneys' ability to reabsorb water, resulting in massive polyuria
Serum osmolality (concentration) is high (unable to stop secretion of water into the kidneys so blood becomes more concentrated) and urine osmolality is low because it is so dilute
The water deprivation test is the simplest and most reliable method for diagnosing central diabetes insipidus but should be done only while the patient is under constant supervision. Serious dehydration may result
|Pituitary dwarfism||Etiology: Achondroplasia (FGFR3 mutation)
Presentation: Short stature/limbs, prominent brow, midfacial hypoplasia
Labs: ↓ GH, ↓ IGF1
BONE AGE: The primary symptom of pituitary dwarfism is lack of height. Therefore, a change in the individual's growth habits will help lead to a diagnosis.
If dwarfism is due to decreased human growth hormone, and not due to a primary skeletal disorder, the child can be treated with human growth hormone treatments to try and stimulate normal growth.
Surgery may be necessary to remove a pituitary adenoma if that is the cause of dwarfism
|Pituitary adenoma and Pituitary neoplastic disease||A 39-year-old woman with bilateral milky breast discharge decreased lateral vision fields, and pituitary mass (prolactinoma)
Most common tumors are microadenomas that are functional (hypersecretion of pituitary hormones), nonfunctional or compressive