Anterior pituitary function hypofunction

Overview anterior pituitary hypofunction also known as Simon's disease (Simmond disease), referring to promote secretion of pituitary hormones can not meet basic human or physical, stress and so on the needs of the situation of SARS group. Etiology : 1. Anterior ischemic necrosis caused postpartum pituitary necrosis were called Sheehan's syndrome (Sheehan Objictive ome). Diabetic microangiopathy may also occur pituitary ischemic infarction. 2. Hypothalamus and pituitary tumors. 3. Pituitary invasive disease leukemia, sarcoidosis and so on. 4. Autoimmune Hypophysitis. 5. Other radiotherapy and chemotherapy; Pituitary resection; The pituitary abscess, tuberculosis, encephalitis, meningitis and other cranial base infectious diseases; empty sella syndrome (rare). 6. Idiopathic more for a single hormone deficiency. Reduce the symptoms of postpartum milk or milk; Hypogonadism, menstrual reduce or amenorrhea, the loss of libido, loss of hair, breast and genital atrophy; man testicular atrophy, impotence, genitalia and prostate atrophy; Hypothyroidism, inattention afraid of the cold, slow, slow heart rate, eyebrow hair sparse; Hypoadrenocorticism, weakness, weakness, loss of appetite, low blood pressure, lighter skin pigment, hypoglycemia, hyponatremia, and so on. GH reduced, short stature. An auxiliary inspection. Determination of endocrine function : they show the pituitary hormone and the corresponding target gland hormones decrease. (1) Blood target gland hormones and their metabolites decreased (T3, T4, FT3, FT4, TSH, ACTH, P, T, E2, FSH, LH); (2) a pituitary hormone (TSH, Gal, LH) for a few days after the excitement of target gland hormones gradually increased, the reaction was delayed, with the primary target identification gland hypofunction. ⑶ TRH, CRH, LHRH exciting test reactions. 2. Sella X-ray : Sella expansion can be found in the hypothalamus or pituitary tumors. Microadenoma sella can be expanded without limitations destruction, CT or MRI will further diagnosis. Diagnosed with anorexia nervosa and target identification gland dysfunction. Primary Hypothyroidism long can also cause TSH pituitary cell proliferation and increased not mistaken as pituitary tumor function of pituitary hypofunction. A treatment, hormone replacement therapy : the shortage of supplementary target gland hormones bringing them closer to the normal secretion pattern. 1. Adrenal cortical hormones : cortisol, .5-37.5 hydrocortisone 12 mg / d; or prednisone 5-7.5 mg, early in the morning and early afternoon hours, twice taking the morning with 2 / 3 the volume, with an afternoon / 3 volume. Encountered stress (such as infection, surgery, trauma, childbirth, etc.) should be used temporary increase 2 -3 times by serious crisis handling. Pituitary dysfunction patients, mostly without salt corticosteroid. 2. Thyroid Hormone : L-thyroxine tablets, from 50 ug / d, gradually increase to 100-200ug / d. Can be oral thyroid tablets. To prevent the increase of adrenal cortical dysfunction, to the drug treatment before or when the combination of glucocorticoid. 3. And gonadotropin hormone : (1) Men : testosterone propionate 25-50mg, intramuscular ,1-2 times / week, heptanoic acid or 200 mg of testosterone, intramuscular 3 items of article number-4 times / week. To promote spermatogenesis can be shared HMG and HCG, the former withered intramuscular 1 -2 support for 3 months or more. The latter weekly intramuscular 2 -3 times, each time 1000IU. (2) female : menopause before using artificial cycle therapy. Ethylene oral propofol 0.5-1 mg / d, is used in conjunction with 24 days, 21-25 days plus progesterone 10mg, intramuscular, withdrawal after the menses. Also with a small dose of androgen, testosterone propionate 12.5mg, intramuscular ,1-2 times / week. 2, TCM : pharmacodynamics more to the interests of blood and vitality of drugs, for example, right identity to the pill, Buzhongyiqitang, Shiquandabu distributed. to improve hormone replacement therapy results. 3, etiology, therapy : pituitary tumor with radiation or surgery and hypothalamic tumors should be treated surgically.