Hyperpituitarism

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Hyperpituitarism
Classification and external resources
ICD-10	E 22
ICD-9	253.1
eMedicine	ped/1092
MeSH	D006964

Hyperpituitarism is the result of excess secretion of adenohypophyseal trophic hormones most commonly by a functional pituitary adenoma. Other causes are hyperplasias and carcinomas of the adenohypophysis, secretion by non-pituitary tumours and certain hypothalamic disorders.

[edit] Clinical manifestations

Depending on the cell type(s) affected, clinical manifestations of hormone excess may include:

When there is an enlargement of the pituitary tissue, hyperpituitarism is often associated with:

Visual field defects, classically bitemporal hemianopia
Radiographic abnormalities of the sella turcica, such as sellar expansion, bony erosion and disuption of the diaphragma sellae
Increased intracranial pressure

Symptoms caused by hormone excess and associated mass effects include:

Hypofunction	Diabetes mellitus types: (type 1, type 2, MODY 1 2 3 4 5 6) · complications (coma, angiopathy, ketoacidosis, nephropathy, neuropathy, retinopathy, cardiomyopathy) insulin receptor (Rabson–Mendenhall syndrome) · Insulin resistance

Hyperfunction	Hypoglycemia · beta cell (Hyperinsulinism) · G cell (Zollinger–Ellison syndrome)

Hyperpituitarism	anterior (Acromegaly, Hyperprolactinaemia, Pituitary ACTH hypersecretion) · posterior (SIADH) · general (Nelson's syndrome)

Hypopituitarism	anterior (Kallmann syndrome, Growth hormone deficiency, ACTH deficiency/Secondary adrenal insufficiency) · posterior (Neurogenic diabetes insipidus) · general (Empty sella syndrome, Pituitary apoplexy, Sheehan's syndrome, Lymphocytic hypophysitis)

Hypothyroidism	Iodine deficiency · Cretinism (Congenital hypothyroidism) · Myxedema · Euthyroid sick syndrome

Hyperthyroidism	Hyperthyroxinemia (Thyroid hormone resistance, Familial dysalbuminemic hyperthyroxinemia) · Hashitoxicosis · Thyrotoxicosis factitia · Graves' disease

Thyroiditis	Acute infectious · Subacute (De Quervain's, Subacute lymphocytic) · Autoimmune/chronic (Hashimoto's, Postpartum, Riedel's)

Goitre	Endemic goitre · Toxic nodular goitre · Toxic multinodular goiter Thyroid nodule

Hypoparathyroidism	Pseudohypoparathyroidism

Hyperparathyroidism	Primary · Secondary · Tertiary · Osteitis fibrosa cystica

Hyperfunction	aldosterone: Hyperaldosteronism/Primary aldosteronism (Conn syndrome, Bartter syndrome, Glucocorticoid remediable aldosteronism) · AME · Liddle's syndrome · 17α CAH cortisol: Cushing's syndrome (Pseudo-Cushing's syndrome) sex hormones: 21α CAH · 11β CAH

Hypofunction/ Adrenal insufficiency (Addison's, WF)	aldosterone: Hypoaldosteronism (21α CAH, 11β CAH) cortisol: CAH (Lipoid, 3β, 11β, 17α, 21α) sex hormones: 17α CAH