Pituitary insufficiency

Lamberts, S. W. J.; Herder, WW de; Lely, AJ van der

doi:10.1016/s0140-6736(98)85043-5

Cited by 145 publications

(98 citation statements)

References 32 publications

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“…In adulthood, hypopituitarism and GHD are often ‘acquired’ as consequences of hypothalamopituitary diseases [1, 7, 33]or represent the persistence of a congenital or acquired pituitary defect that had been diagnosed in childhood [1, 34, 35, 36, 37]. GH is usually the first of the anterior pituitary hormones to be affected [7, 34, 35].…”

Section: Diagnosis Of Adult Ghd: Current Guidelinesmentioning

confidence: 99%

“…GH is usually the first of the anterior pituitary hormones to be affected [7, 34, 35]. Thus, GHD can be considered to be a hallmark symptom indicating possible impaired pituitary function, which could evolve and spread to other pituitary axes.…”

Section: Diagnosis Of Adult Ghd: Current Guidelinesmentioning

confidence: 99%

“…Adult patients who have hypothalamopituitary masses either before or even more so after therapy (neurosurgery and/or radiotherapy and/or medical therapy) are at extremely high risk of severe GHD (>80%); thus, these patients are at ‘obvious’ rather than just high risk of severe GHD and routine evaluation of their pituitary function is mandatory [33, 35]. The same statement applies to patients who were diagnosed as having either congenital or acquired GHD in childhood.…”

Section: Diagnosis Of Adult Ghd: Current Guidelinesmentioning

confidence: 99%

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Insulin-Like Growth Factor I Levels and the Diagnosis of Adult Growth Hormone Deficiency

Aimaretti¹,

Corneli²,

Rovere³

et al. 2004

Horm Res Paediatr

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The current guidelines state that, within the appropriate clinical context, the diagnosis of adult growth hormone (GH) deficiency must be made biochemically using provocative tests. Measurement of insulin-like growth factor I (IGF-I) and binding protein 3 (IGFBP-3) levels cannot always distinguish between healthy and GH-deficient individuals. In particular, IGFBP-3 as a marker of GH status is clearly less sensitive than IGF-I and there is general agreement that its measurement does not provide useful diagnostic information. However, the diagnostic value of measuring IGF-I levels has been revisited recently. It has been confirmed that normal IGF-I levels do not rule out severe GH deficiency (GHD) in adults, in whom the diagnosis has therefore to be based on the demonstration of severe impairment of the peak GH response to provocative tests. It has also been emphasized that very low IGF-I levels in patients with high suspicion of GHD could be considered to be definite evidence for severe GHD. This assumption particularly applies to patients with childhood-onset, severe GHD or with multiple hypopituitary deficiencies acquired in adulthood. In addition, the use of IGF-I levels to monitor the efficacy and adequacy of recombinant human GH replacement remains widely accepted.

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Section: Diagnosis Of Adult Ghd: Current Guidelinesmentioning

confidence: 99%

Section: Diagnosis Of Adult Ghd: Current Guidelinesmentioning

confidence: 99%

Section: Diagnosis Of Adult Ghd: Current Guidelinesmentioning

confidence: 99%

See 1 more Smart Citation

Insulin-Like Growth Factor I Levels and the Diagnosis of Adult Growth Hormone Deficiency

Aimaretti¹,

Corneli²,

Rovere³

et al. 2004

Horm Res Paediatr

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“…Die Hypophysenvorderlappeninsuffizienz ist der teilweise oder komplette Verlust der Hormonsekretion des Hypohysenvorderlappens, der durch die Hypophyse selbst oder aber durch eine hypothalamische Störung induziert wird [8]. Angegeben wird eine Inzidenz von 12-42 pro Million und Jahr und eine Prävalenz von 300-455 pro Million [6,9].…”

Section: Hypophysenvorderlappeninsuffizienzunclassified

78-jährige Patientin mit Durchfall, Abgeschlagenheit und depressivem Syndrom

Hochhausen

Schümann

2008

Internist

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A 78-year-old woman was admitted with diarrhea, abnormal fatigue, and depression. Routine diagnostic tests were to a large extent without pathological findings. Suppressed TSH was initially considered as subclinical hyperthyreosis because of substitution with L-thyroxin. The endocrinological diagnostics showed hypopituitarism because of an empty sella. After substitution with hydrocortisone and adapted L-thyroxin the patient recovered promptly. Diarrhea, abnormal fatigue, and depression might be hints for hypopituitarism with hypocortisolism.

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“…Die Häufig-keit einer Hypophyseninsuffizienz wird mit 8-10 Neuerkrankungen pro Million Erwachsene und Jahr angegeben [1].…”

Section: Therapie Der Hypophyseninsuffizienzunclassified

Substitutionstherapie mit Hormonen

2003

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Die Behandlung von Patienten mit Hormonausfällen und ihre Substitution ist für den endokrinologisch tätigen Arzt eine wesentliche Aufgabe. Dabei kann der Substitutionsbedarf einzelne oder, z. B. bei Erkrankungen der Hypophyse, mehrere Hormone betreffen. Die Frage, ob eine Hormonsubstitution erfolgen sollte, ist von zahlreichen Faktoren wie Alter, Geschlecht und Begleiterkrankungen des Patienten abhängig. Unumstritten ist die Notwendigkeit einer Substitution mit Hydrokortison bei Nachweis einer Nebennierenrindeninsuffizienz oder mit L-Thyroxin bei einer Hypothyreose bei allen Patienten. Die Substitution mit Östrogen-oder Testosteronpräparaten ist im jüngeren Alter für das physische und psychische Wohlbefinden und für den Erhalt der Knochenmasse wesentlich. Bei Patienten mit gesichertem Wachstumshormonmangel sollte die Therapie möglichst im Rahmen von Verlaufsbeobachtungen erfolgen. Der Einsatz der postmenopausalen Hormonersatztherapie mit Östrogenen muss nach aktuellen Untersuchungen kritisch gesehen werden und ist im Wesentlichen auf die Beseitigung der Symptome in den Wechseljahren gerichtet.

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Pituitary insufficiency

Cited by 145 publications

References 32 publications

Insulin-Like Growth Factor I Levels and the Diagnosis of Adult Growth Hormone Deficiency

Insulin-Like Growth Factor I Levels and the Diagnosis of Adult Growth Hormone Deficiency

78-jährige Patientin mit Durchfall, Abgeschlagenheit und depressivem Syndrom

Substitutionstherapie mit Hormonen

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