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At least 55 records · Page 3Linked to original sources
PubMed1986

Parathyroid mitogenic activity in plasma from patients with familial multiple endocrine neoplasia type 1.

Hyperplasia of the parathyroid glands is a central feature of familial multiple endocrine neoplasia type 1. We used cultured bovine parathyroid cells to test for mitogenic activity in plasma from patients with this disorder. Normal plasma stimulated [3H]thymidine incorporation, on the average, to the same extent as it was stimulated in a plasma-free control culture. This contrasted with the results of the tests with plasma from patients with familial multiple endocrine neoplasia type 1, in which parathyroid mitogenic activity increased 2400 percent over the control value (P less than 0.001). Plasma from these patients also stimulated the proliferation of bovine parathyroid cells in culture, whereas plasma from normal subjects inhibited it. Parathyroid mitogenic activity in plasma from the patients with familial multiple endocrine neoplasia type 1 was greater than that in plasma from patients with various other disorders, including sporadic primary hyperparathyroidism (with adenoma, hyperplasia, or cancer of the parathyroid), sporadic primary hypergastrinemia, sporadic pituitary tumor, familial hypocalciuric hypercalcemia, and multiple endocrine neoplasia type 2 (P less than 0.05). Parathyroid mitogenic activity in the plasma of patients with familial multiple endocrine neoplasia type 1 persisted for up to four years after total parathyroidectomy. The plasma also had far more mitogenic activity in cultures of parathyroid cells than did optimal concentrations of known growth factors or of any parathyroid secretagogue. This mitogenic activity had an apparent molecular weight of 50,000 to 55,000. We conclude that primary hyperparathyroidism in familial multiple endocrine neoplasia type 1 may have a humoral cause.

Adenoma↗
PubMed2006

Thyroid color flow Doppler sonography: an adjunctive tool for differentiating patients with inappropriate thyrotropin (TSH) secretion due to TSH-secreting pituitary adenoma or resistance to thyroid hormone.

BACKGROUND: Thyrotropin (TSH)-secreting pituitary adenoma (TSHoma) and resistance to thyroid hormone (RTH) are two forms of inappropriate TSH secretion. Thyroid blood flow is largely TSH dependent. OBJECTIVE: To assess whether thyroid blood flow may help to differentiate TSHoma and RTH. DESIGN: Intrathyroidal color flow Doppler sonography (CFDS) pattern and peak systolic velocity (PSV) were assessed at baseline and during T(3) suppression test on eight consecutive patients with TSHoma and 10 with RTH. MAIN OUTCOME: All controls had CFDS pattern 0. Three RTH patients had pattern I and seven had pattern II. Two TSHoma patients had pattern I, five had pattern II, and one had pattern III. PSV at baseline was 3.8 +/- 1.3 cm/s in controls, 8.8 +/- 2.5 cm/s in RTH, 11.1 +/- 2.7 cm/s in TSHoma (p < 0.0003 vs. controls, p = 0.087 RTH vs. TSHoma). After T3 suppression test, PSV values were lower in RTH than in TSHoma (4.6 +/- 1.8 vs. 7.7 +/- 2.6 cm/s, p = 0.008). PSV values and CFDS pattern normalized in nine and eight RTH patients, respectively, after T(3) suppression test; conversely, only one TSHoma patient had a normalization of PSV values, and none had a normalization of CFDS pattern (p < 0.003 vs. RTH). CONCLUSIONS: Both RTH and TSHoma have increased CFDS pattern and PSV values; however, after T(3) both parameters normalized in most patients with RTH but not in those with TSHoma. Accordingly, CFDS pattern and PSV are adjunctive tools to differentiate these two forms of inappropriate TSH secretion.

Adenoma↗
PubMed2002

Hyponatremia in a pediatric stroke patient: syndrome of inappropriate antidiuretic hormone secretion or cerebral salt wasting?

OBJECTIVE: To determine the potential role of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) in the pathogenesis of cerebral salt wasting. DESIGN: Clinical case report. SETTING: Regional pediatric intensive care unit. PATIENT: A 3-yr-old boy with a cerebral infarct secondary to traumatic carotid artery dissection who developed hyponatremia associated with weight loss and excessive renal sodium excretion on the sixth day after hospitalization. MEASUREMENTS AND MAIN RESULTS: Plasma concentrations of ANP, BNP, antidiuretic hormone, and renin were determined serially and compared with concentrations measured in a group of eight healthy children undergoing elective surgical procedures. Compared with controls, ANP and BNP plasma concentrations on the eighth day after hospitalization were increased 1.9-fold and 7.7-fold, respectively. Thereafter, the course of ANP and BNP paralleled that of sodium and H2O excretion and remained elevated until the 14th (BNP) and 16th (ANP) days after hospitalization. Serum antidiuretic hormone and renin concentrations were within normal ranges during the entire observation period. CONCLUSION: Cerebral salt wasting is associated with elevated plasma concentrations of ANP and BNP. Natriuretic peptides may play a role in the pathogenesis of this syndrome.

Atrial Natriuretic Factor↗
PubMedDate not supplied

Common disorders of the pituitary gland: hyposecretion versus hypersecretion.

An understanding of pituitary disorders requires much more than a knowledge of the definitions associated with them. To grasp fully their complexity, one must recognize not only the powerful role the pituitary gland plays in the endocrine system, but also its effects on homeostasis throughout the entire human body, its association with the hypothalamus, and ultimately its associated end organs. Because of the many hormones stored or produced by the pituitary, associated disorders often are confusing and challenging. However, by simplifying the classification of these disorders into the categories of hyposecretion and hypersecretion, the understanding of pituitary disorders is made simple, and the associated interventions become apparent.

Adrenocorticotropic Hormone↗
PubMed1988

Articular manifestations of acromegaly.

Forty-five patients with acromegaly or gigantism were reviewed for musculoskeletal abnormalities. Abnormalities of peripheral joints occurred in 74% of the patients and spinal involvement in 47%, leading to significant morbidity. Joint abnormalities most frequently affected the large joints (hips, knees and shoulders) but the wrist and hand were also involved. The radiological features of acromegalic arthropathy are described, including vertical widening of the hip joint, enthesopathy and osteophytosis. A favourable response to treatment is associated with a less severe arthropathy and a good functional outcome.

Adolescent↗
PubMed1995

Primary empty sella: differences and similarities between children and adults.

To identify possible differences between empty sella in children and adults we studied 43 subjects (age 13.6 +/- 5.4 years, range 4.1-27 years) with hypothalamic-pituitary disorders and empty sella at magnetic resonance imaging. Pituitary function, presence of non-endocrine symptoms, perinatal history, sellar volume, pituitary height, midline or intrasellar anatomical abnormalities were evaluated. Twenty subjects had isolated growth hormone deficiency, 17 multiple pituitary hormone deficiency and 6 puberty disorders (3 precocious puberty, 2 idiopathic delayed puberty, 1 Kallmann syndrome). The group with multiple pituitary hormone deficiency had a higher percentage of subjects with complete empty sella, i.e. pituitary height < 2 mm (p = 0.016), or intrasellar anatomical abnormalities (p = 0.0002) than the other groups. The subjects with puberty disorders had a mean sellar volume higher than the other groups (p < 0.05). Apart from pituitary dysfunction, symptoms of the empty sella syndrome were infrequent (9.3% of cases) in our subjects. The age of our subjects, the frequent association between empty sella and pituitary dwarfism and the non-enlarged sellae suggest a different aetiology, perhaps congenital, for empty sella in our subjects. As in adults, empty sella may be associated with both pituitary hypo- and hyperfunction.

Adolescent↗
PubMed2007

L-thyroxin treatment in infants with hyperthyrotropinaemia: 4-year experience.

Hyperthyrotropinaemia, in which normal levels of T4 occur in association with raised thyroid stimulating hormone (TSH), is usually picked up on neonatal screening. High TSH level can continue for a long time in some of the cases. There is no consensus concerning the follow-up or treatment plan for hyperthyrotropinaemia. In this study, results of a 4-year follow-up of 36 cases who had been medically treated are discussed. Low-dose (5 microg/kg/day) L-thyroxin treatment was carried out in 36 cases that had 5 mU/l or higher TSH and showed exaggerated response to TRH test. Dose was decreased to 2-3 microg/kg/day in 24 of these patients during 6 months follow-up. The drug was stopped in three cases because of the development of biochemical hyperthyroidism. Denver developmental assessment test was applied to all cases at the end of the third year. All patients showed a normal development in relation to their age. According to our results, cases with hyperthyrotropinaemia need to be followed regularly for a long time and a need for low-dose L-thyroxin treatment may exist at ages varying from patient to patient.

Antithyroid Agents↗
PubMed1996

The evaluation and management of subclinical pituitary disease.

The advent of sophisticated and sensitive radiologic techniques has undoubtedly improved the evaluation of patients with established endocrine disease. An inevitable consequence of the increased sensitivity and widespread availability of modern imaging is, however, the discovery of apparently asymptomatic mass lesions in endocrine tissues. The clinician is then required to determine the appropriate degree of often uncomfortable and costly investigation in a patient with no overt disease. This article attempts to provide guidelines for the management of the 'pituitary incidentaloma', a pituitary mass lesion evident on a computed tomography or magnetic resonance imaging scan performed for a reason other than the evaluation of the pituitary gland.

Acromegaly↗
PubMed1988

Marginal and folliculo-stellate cells of the pituitary gland of the rat. A comparative morphometric study in lactating animals.

We examined non-granulated pituitary cells (folliculo-stellate cells and anterior and posterior marginal cells of the pituitary cleft) in lactating and virgin female rats by means of electron microscopy and morphometry. Ultrastructure and morphometric parameters of the cells lining the pituitary cleft were similar in the two groups of animals. On the contrary, folliculo-stellate cells showed a marked nucleocytoplasmic activation in lactating rats in the electron microscope, which was confirmed by morphometric measurements. These results are not consistent with the hypothesis that the three cell types share the same reactivity during pituitary hyperfunction and that they have a common function, as suggested by purely morphological studies in various endocrine conditions. We believe that quantitation of cell response during such stimuli could be useful to further elucidate this matter.

Animals↗
PubMed1993

Secretory granules and granins in hyperstimulated male rat gonadotropes.

Granins are acidic proteins co-localized with peptides in secretory granules of many endocrine cells. They are thought to participate in certain steps of the regulated secretory pathway. This is of particular interest in rat pituitary gonadotropes, which in most cases contain both gonadotropins (follicle-stimulating hormone, FSH and luteinizing hormone, LH) and two granins (chromogranin A, CgA and secretogranin II, Sg II). Therefore, we investigated male rat gonadotropes ultrastructurally and for the cellular and subcellular localization of gonadotropins/granins under normal conditions and after stimulation by luteinizing hormone-releasing hormone (LHRH) or castration. Typical gonadotropes of controls contained differently composed secretory granules: small granules showed immunoreactivity for LH and SgII and larger granules were immunoreactive for FSH and CgA and to a lesser extent, for LH. Stimulated gonadotropes showed hypertrophy or hyperplasia and RIA for plasma LH levels showed a 30-70-fold increase. In stimulated cells a third type of secretory granule became prominent. These "intermediate" granules had an electron-dense core immunoreactive for LH and SgII, whereas CgA labeling was confined to a less electron-dense outer region. (In stimulated gonadotropes, FSH immunoreactivity could be shown effectively only at the light microscopic level.) Intermediate granules developed from structures resembling condensing vacuoles. They began to exhibit their typical double structure as they budded off from the trans-Golgi network. It therefore appears that CgA and SgII participate in establishing two different routes of the regulated pathway in gonadotropes. Therefore, immunocytochemistry of the granins seems to be a suitable approach to investigating secretory pathways in these endocrine cells.

Animals↗