Hyperpituitarism
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Hyperpituitarism
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Laboratory value | Result |
Sodium | 146 mmol/L |
Potassium | 3.9 mmol/L |
Bicarbonate | 26 mmol/L |
Fasting glucose | 137 mg/dL |
24-hour urine cortisol* | 72 µg/day |
Serum ACTH** | 35 pg/mL |
*Normal range: 4-40 µg/day
**Normal range: 5-20 pg/mL
The serum cortisol levels are significantly reduced in response to a high-dose of dexamethasone. Which of the following is the most likely underlying pathophysiology for this patient’s condition?
Summary
Hyperpituitarism refers to a condition in which the pituitary gland secretes abnormally high levels of pituitary hormones. Hyperpituitarism typically results from a pituitary adenoma, which overproduces one or more of the pituitary hormones.
The symptoms depend on the type and size of the adenoma and the hormones it produces. However, hyperpituitarism associated with large adenomas may cause mass effect, which is characterized by headache and possibly bitemporal hemianopsia due to compression of the optic chiasma. Other common hormone-related symptoms may include: Abnormal growth or enlargement of the head, hands, and feet Developmental delays in children Diabetes mellitus Reproductive problems in men and women Enlarged thyroid gland (goiter) Increased blood pressure