Apart from diagnosing hyperprolactinaemia and hypopituitarism, prolactin levels are often checked by physicians in patients that have suffered a seizure, when there is doubt as to whether they have had an epileptic seizure or a non-epileptic seizure.
32.
Hypopituitarism specifically growth hormone deficiency has been reported as the only most common late morbidity of this treatment; GHD has been reported in 36 % and 68 % of the patients undergoing post pituitary RT for Cushing's disease.
33.
Some systemic conditions may cause delayed tooth development, such as nutritional factors, endocrine disorders ( hypothyroidism, hypopituitarism, hypoparathyroidism, pseudohypoparathyroidism ), undiagnosed and untreated celiac disease, anemia, heavy metal intoxication or tobacco smoke, among others.
34.
Surgery is offered if there is failure of medical therapy or rapid growth of lesion, with specific options including stereotactic thermocoagulation, gamma knife radiosurgery, and physical resection by infundibulum and the amount of hormonal disturbance at presentation can help predict risk of hypopituitarism following surgery.
35.
Difficult situations arise in deficiencies of the hypothalamus-pituitary-gonadal axis in people ( both men and women ) who experience infertility; infertility in hypopituitarism may be treated with subcutaneous infusions of FSH, human chorionic gonadotropin which mimics the action of LH and occasionally GnRH.
36.
Deficiency of ACTH is a sign of secondary adrenal insufficiency ( suppressed production of ACTH due to a impairment of the pituitary gland or hypothalamus, cf . hypopituitarism ) or tertiary adrenal insufficiency ( disease of the hypothalamus, with a decrease in the release of corticotropin releasing hormone CRH ).
37.
Dwarfism may also be caused by malnutrition or other hormonal deficiencies, such as insufficient growth hormone secretion, hypopituitarism, decreased secretion of growth hormone-releasing hormone, deficient growth hormone receptor activity and downstream causes, such as insulin-like growth factor 1 ( IGF-1 ) deficiency.
38.
After an episode of pituitary apoplexy, 80 % of people develop hypopituitarism and require some form of hormone replacement therapy . 60 80 % require hydrocortisone replacement ( either permanently or when unwell ), 50 60 % need thyroid hormone replacement, and 60 80 % of men require testosterone supplements.
39.
It has been recommended in the current Clinical Practice Guidelines ( 2011 ) by the Endocrine Society-a professional, international medical organization in the field of endocrinology and metabolism-that all patients with pituitary incidentalomas undergo a complete medical history and physical examination, laboratory evaluations to screen for hormone hypersecretion and for hypopituitarism.
40.
Other tests that may assist in the diagnosis of hypopituitarism, especially if no tumor is found on the MRI scan, are ferritin ( elevated in hemochromatosis ), angiotensin converting enzyme ( ACE ) levels ( often elevated in sarcoidosis ), and human chorionic gonadotropin ( often elevated in tumor of germ cell origin ).
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