Week 8: Endocrine System Case Studies

Growth Hormone Hypersecretion

Hypersecretion of the Growth Hormone will affect a person differently depending on the stage of life they are in

Childhood- Pituitary Gigantism

• symptoms:

  • increased linear growth

Adulthood- Acromegaly

• symptoms:

  • increased periosteal bone growth

  • increased organ size

  • increased hand and foot size

  • coarsening of facial features

Growth Hormone Hyposecretion

Hyporsecretion of the Growth Hormone will affect a person differently depending on the stage of life they are in

Infancy- Growth Hormone Deficiency

• symptoms:

  • younger looking face given age

  • slow hair and nail growth

  • delayed teeth development

Childhood- Pituitary Dwarfism

• symptoms:

  • short stature

  • delayed sexual development

Adulthood- Adult Growth Hormone Deficiency (AGHD)

• symptoms:

  • hypoglycemia

  • sweating

  • heart palpitations (hearing your heartbeat)

Antidiuretic Hormone Deficiency (ADH hyposecretion)

Diabetes Insipidus- abnormal increase in urine output, fluid intake, and often thirst

• symptoms:

  • dilute urine (low osmolality)

  • Increased urine frequency

• cause:

  • death of ADH producing cells in hypothalamus/posterior pituitary gland

Antidiuretic Hormone Hypersecretion

Syndrome of Inappropriate ADH Secretion (SIADH)

• symptoms:

  • hyponatremia (low levels of sodium in blood)

  • elevated urine osmolality

  • elevated sodium excretion

  • decreased serum (part of blood made up of water) osmolality

• cause:

  • hypovolemia- decreased volume of circulating blood in the body

  • ADH Secreting tumor (non-pituitary)- comes from hypothalamus

hyperparathyroidism

• affects the parathyroid hormone

• leaching of bone minerals

• symptoms:

  • depression

  • joint/bone pain

  • trouble concentrating

  • tiredness

  • loss of appetite

hypoparathyroidism

• affects the parathyroid hormone

• hypocalcemia - low blood calcium levels

• symptoms:

  • muscle cramps

  • mood changes

  • hair loss

  • rough skin

aldosterone hyposecretion

• ECF volume contraction

• hyperkalemia - high levels of potassium in the blood

• metabolic acidosis

aldosterone hypersecretion

• ECF volume expansion

• hypokalemia

• metabolic alkalosis (conn’s syndrome)

Hypothyroidism

• hyposecretion of TSH will affect a person differently depending on the stage of life they are in

• hypothyroidism can occur separate to both cretinism and myxedema, however hypothyroidism is an essential component and cause of both

• TSH increases, and T₃ and T₄ decreases

Children- Cretinism

• causes: iodine deficiency in diet during pregnancy

• hormone abnormalities involved: congenital hypothyroidism

• symptoms:

  • low metabolic rate

  • developmental delay

  • short stature

  • thick tongue and neck

  • goiter

Adults- Myxedema

• causes:

  • autoimmune disease

  • radiation therapy

  • surgical removal of thyroid

  • iodine deficiency

  • immunotherapy

• hormone abnormalities involved: hypothyroidism

• symptoms:

  • low metabolic rate

  • swelling of skin, most commonly in face

  • tiredness/lethargy

  • low heart rate

  • goiter

hyperthyroidism

Graves Disease

• TSH decreases, T₃ and T₄ increase

• Graves’ disease causes hyperthyroidism however hyperthyroidism can happen separate from Graves’ disease

• Causes: autoimmune disorder

• hormone abnormalities involved: overactive thyroid leading to hyperthyroidism

• symptoms:

  • increased metabolic rate

  • sweating

  • goiter

  • rapid/irregular heartbeat

  • weight loss

  • nervousness

  • protruding eyeballs (exophthalmos)

Addison’s Disease

• causes:

  • autoimmune dysfunction

  • decreased adrenal cortex function

  • can be caused by decreased ATCH levels

• hormone abnormalities involved:

  • decreased production of all adrenal cortex hormones (glucocorticoids, mineralcorticoids, adrenal androgens)

• symptoms:

  • loss of glucocorticoids causes: hypoglycemia, weight loss, nausea, vomiting, weakness

  • loss of mineralcorticoids causes: hyperkalemia, metabolic acidosis, hypotension, low sodium reabsorption

  • loss of adrenal androgens causes: decreased pubic and axillary hair, decreased libido

  • loss of ATCH causes: hyperpigmentation of skin

Cushing’s Syndrome

• causes:

  • pituitary gland tumor/abnormality

  • long term high dose of certain steroids

• hormone abnormalities involved: hypersecretion of glucacorticoids (mainly cortisol)

• symptoms:

  • hyperglycemia

  • abdominal obesity

  • muscle wasting - losing muscle mass

  • bone necrosis (cell death)

  • cushingoid signs (high levels of cortisol)

  • a tendency to bruise and poor wound healing

  • hypertension

  • virilization of females (hair growth on face/body, amenorrhea (no period), acne)

catecholamine hypersecretion

• causes: pheochromocytoma (tumor on chromaffin cells)

• hormone abnormalities involved: hypersecretion of epinephrine and norepinephrine (primarily EPI)

• symptoms: uncontrolled nervous system

  • hyperglycemia

  • increased metabolic rate

  • tachycardia

  • hypertension

  • sweating

  • anxiety/intense nervousness

diabetes mellitus

Type I: Insulin Dependent Diabetes Mellitus (IDDM)

• cause: beta cells in pancreas do not produce enough insulin or no insulin at all

• characteristics: usually early onset during childhood or adolescence

• treatment: insulin injections that act in place of a functional pancreas

Type II: Non- Insulin Dependent Diabetes Mellitus

• cause: insulin receptors are not sensitive enough anymore (don’t detect)

• characteristics: diagnosed in older adults, heavily related to obesity

• treatment: treated with diet and exercise as well as hypoglycemic medications