What does hypofunction of the pituitary gland lead to? Typical forms of adenohypophysis pathology. Biological effects of neurohypophysis hormones

The pituitary gland, despite its relatively small sizes, plays an extremely important role in the human body. The main function of this part of the brain is to regulate activity endocrine glands person. To achieve this, the pituitary gland produces a number of its own hormones.

Maintenance hormonal balance in the body is impossible without the relationship between the pituitary gland and another part of the brain - the hypothalamus. If the production of necessary hormones by one of the endocrine glands decreases, the hypothalamus sends a corresponding signal to the pituitary gland, to which the latter responds by increasing the production of its hormones. Due to this, the work of a specific gland is stimulated. If in the blood, on the contrary, there is increased concentration any hormone, the hypothalamus transmits a signal to the pituitary gland about the need to suppress the work of one of the endocrine glands.

The role of the pituitary gland in the human body

In order to understand what the pituitary gland of the brain is responsible for, you need to know what hormones it produces.

All these protein hormones necessary for the flow metabolic processes in the body, are produced by the anterior lobe of the pituitary gland. Its posterior lobe is responsible for the production of two other hormones:

• Vasopressin. Protects the body from dehydration by regulating kidney activity and controlling the amount of water excreted in urine. In addition, vasopressin regulates the amount of sodium in the blood, stimulating, if necessary, its excretion from the body along with urine.
• Oxytocin. Responsible for contraction of smooth muscles of the urinary and gallbladder and intestines. Provides contraction of the uterine muscles during labor and also participates in the process of milk production during lactation.

What is the risk of hypofunction of the pituitary gland?

Normal functioning of the pituitary gland is the guarantor of a person’s long life and his good health. If its activity is disrupted, there may be a lack of hormones produced or, conversely, an excessive amount of them in the blood. In the first case we're talking about about hypofunction of the pituitary gland. Its occurrence is fraught with a number of negative consequences for the body:

• disruption of activities thyroid gland;
• hypothyroidism due to a severe lack of hormones;
• the likelihood of developing dwarfism (dwarfism);
• delayed puberty;
• sexual dysfunction, etc.

The causes of such disturbances in the functioning of the pituitary gland may be tumors, inflammatory processes and ischemic lesions.

Pituitary dwarfism

Another name for this disease is dwarfism or short stature. Develops due to insufficient production of growth hormone by the pituitary gland in childhood. Such a disorder is usually combined with a lack of luteinizing and follicle-stimulating hormones in the bodies of boys and girls, respectively, which leads to disturbances in the natural course of sexual development. This problem has a genetic nature, that is, hypofunction of the pituitary gland in this case is caused by defects in genes.

Simmonds syndrome

In this case, the cause of weak hormone production is past infections(tuberculosis, encephalitis, syphilis), brain injuries or disorders vascular nature. In this case, problems in the functioning of the pituitary gland lead to the development of hypothyroidism and gradual disruption of the functioning of all endocrine glands. The first signs of the disease are sudden weight loss, loss of appetite, general weakness, dry skin and hair, etc.

Diabetes insipidus

It develops due to a lack of vasopressin produced by the posterior lobe of the pituitary gland. The hormone is responsible for maintaining normal level fluid in the body, therefore, in case of acute shortage, almost all the fluid is excreted in the urine. The reason for this phenomenon may be hereditary predisposition, and trauma, tumors, or infections of the pituitary gland.

Most full details The condition of the pituitary gland can be obtained through MRI of the brain. This type of examination allows us to identify possible neoplasms in this area and assess the degree of disruption of hormone production. And MRI of the pituitary gland with contrast allows you to obtain reliable information about the presence of even microscopic adenomas or monitor the condition of the pituitary gland after surgery.

Hormones are deposited in the posterior lobe of the pituitary gland vasopressin And oxytocin, which are synthesized by cells hypothalamus and along axons they enter the neurohypophysis. The posterior lobe of the pituitary gland secretes two main hormones: vasopressin and oxytocin. The second hormone of the posterior lobe of the pituitary gland, oxytocin, stimulates contraction of the uterine muscles; its role is especially important during childbirth. They are formed in the neurosecretory cells of the supravisual and periventricular nuclei of the hypothalamus. Neurosecretory cells combine nervous and endocrine functions. Receiving impulses coming to them from other parts of the nervous system, they transmit them in the form of neurosecretions, which are moved by axoplasmic current to the axon endings in the posterior lobe of the pituitary gland. Here the axons form contacts with the capillaries and the secretion enters the blood.

Antidiuretic hormone regulates the body's water content by increasing the reabsorption of water in the collecting ducts of the kidney and thereby reducing diuresis. This hormone is also called vasopressin, since by causing contraction of non-striated muscle tissue of arterioles, the hormone vasopressin increases blood pressure.

Hyperfunction of the posterior pituitary gland leads to persistent hypertension, which is associated with increased absorption of water in the renal tubules and the release of vasopressin into the blood.

With hypofunction of the posterior lobe of the pituitary gland, the disease diabetes insipidus develops, in which the release of vasopressin and its antidiuretic effect decrease, and therefore diuresis significantly increases, and severe thirst appears. In this case, the kidneys lose their ability to concentrate urine and diuresis increases many times; administration of an extract of the posterior lobe of the pituitary gland or exposure to the hypothalamus region terminates the disease. When the pituitary gland is severely damaged (by a tumor, tuberculosis, etc.), a sharp hypofunction occurs, leading to the phenomena of pituitary cachexia, characterized by severe exhaustion, atrophy of bones, the genital apparatus, loss of teeth and hair. With pathology of the pituitary gland, the metabolism and functions of other endocrine glands are disrupted. Total hypofunction of the hypothalamic-pituitary system. Manifested by the development of the disease Simmonds(panhypopituitarism, pituitary cachexia, hypothalamic-pituitary insufficiency and its variant - Scheen's disease). Disease occurs as a result of damage (atrophy, sclerosis, necrosis) of 90-95% of the pituitary tissue due to severe labor hemorrhages and postpartum complications, as well as infectious, toxic, vascular (systemic collagen diseases and thromboembolic complications), traumatic (especially accompanied by intracerebral hemorrhages), autoallergic and tumor lesions of the adenohypophysis and (or) hypothalamus, prolonged fasting. Pathogenesis and the clinical picture of the disease are determined by insufficient synthesis of various tropic hormones (ACTH, TSH, GTH, STH, sometimes vasopressin) and secondary hypofunction of the adrenal glands, thyroid and gonads against the background of progressive muscle atrophy and internal organs due to GH deficiency. As a result, there is a loss of body weight from 3-6 kg to 20-25 kg per month, adynamia, stupor, hyponatremia, hypoglycemia, dyspeptic symptoms, arterial hypotension, hypothermia, bone decalcification, osteoporosis, polyneuritis, pain syndrome, convulsions develop and increase. mental disorders (depression, complete prostration, complete indifference to the environment, various mental disorders), cachexia, collapse and coma. Treatment. They carry out hormone replacement therapy, tumor removal, anti-inflammatory therapy, prescribe vitamins, anabolic agents, and high-calorie nutrition. With the development of collapse and coma, glucocorticoids, cardiac and vascular drugs are used.

31. Causes and mechanisms typical violations reservoir, secretory and motor functions of the stomach, their relationship. Types of pathological secretion, their characteristics.

Digestive disorders in the stomach

Digestive disorders in the stomach are based on partial, and more often combined, disorders of the secretory, motor, absorption, barrier and protective functions of the stomach.

There are two phases in gastric secretion: complex reflex and neurochemical. In each of these phases, approximately the same amount of gastric juice is released, and gastric motility is uniform (Fig. 24.1, A). Under pathological conditions, five types of gastric secretion and motility are distinguished:

Excitable type(Fig. 24.1, B). It is characterized by a rapid and intense increase in secretion in the first phase, its long continuation and a relatively slow decline in the second phase.

However, the ratio of secretion intensity between phases remains normal. Gastric motility is characterized by hyperkinesis.

Brake type(Fig. 24.1, B). Secretion and gastric motility are reduced in both phases.

Asthenic type(Fig. 24.1, D). In the first phase, there is a rapid increase in secretion and rapid motility is observed, but this process does not last long. In the second phase, there is a rapid decline in secretion and gastric hypokinesia.

Inert type(Fig. 24.1, D). In the first phase, secretion increases slowly, but then it remains at a high level for a long time and slowly fades away. Motor skills behave similarly.

Chaotic type(Fig. 24.1, E). It is characterized by the absence of any patterns in the dynamics of gastric secretion and motility.

The pituitary gland is a small gland located at the base of the brain. Its main function is to transmit information from the hypothalamus ( main regulator metabolism) to peripheral endocrine glands.

Types of pituitary dysfunction and their causes

There are many types of disorders of hormone synthesis by the pituitary gland, but they can be divided into two large groups:

• associated with excess hormones (hyperfunction of the pituitary gland). With hyperfunction of the pituitary gland, gigantism, thyrotoxicosis, acromegaly, and Itsenko-Cushing's disease develop.
• associated with a deficiency of one or more pituitary hormones (hypofunction). This is cretinism diabetes insipidus, dwarfism, Sheehan's disease, Simmonds' disease.

These disorders can be either congenital (as a result of a violation of the intrauterine formation of an organ) or acquired. Hyperfunction and hypofunction of the pituitary gland in adults is often acquired. The reasons may be:

• brain injuries;
• autoimmune diseases;
• neoplasms;
• taking certain medications;
• heavy infectious diseases(previous meningitis, encephalitis);
• childbirth;
• previous cerebral circulatory disorders (heart attack, stroke);
• drug use.

Important! Most of these reasons lead to the development of hypofunction of the pituitary gland, most common cause hyperfunction is a hormone-producing tumor.

Adenohypophysis dysfunction

The main hormones of the anterior pituitary gland are:

• somatotropic (GH);
• thyroid stimulating (TSH);
• adrenocorticotropic (ACTH);
• prolactin;
• follicle-stimulating (FSH) and luteinizing (LH).

Each of them regulates its own metabolic processes. A change in the amount of these hormones leads to the development of various pathological symptoms.

For example, an excess of growth hormone leads to diseases such as gigantism and acromegaly.

Gigantism develops as a result large quantity STG during the period active growth person. As a result, by the age of 18, the height of women can be 190 cm, men - 2 meters or more.

In addition, gigantism is accompanied by symptoms such as:

• headache;
• frequent numbness of the limbs and paresthesia;
• weakness;
• joint pain;
• excessive thirst (GH suppresses insulin secretion);
• violation menstrual function in women and (often) erectile in men.

Acromegaly develops in people due to excess growth hormone after the closure of growth plates. This disease is disfiguring in nature. Excessive disproportionate growth of the chin, nose, hands, and feet occurs.

• arterial hypertension;
• obesity;
• arthralgia;
• sexual dysfunction;
• sleep apnea syndrome.

As a result of a lack of growth hormone, dwarfism develops.

Important! Treatment of dwarfism is possible only if there are open areas of bone growth, i.e. up to 16-17 years old.

Thyroid-stimulating hormone is a hormone that regulates the function of the thyroid gland. With hyperfunction of the pituitary gland with excessive synthesis of TSH, thyrotoxicosis develops.

IN clinical picture observed:

• sudden weight loss;
• tachycardia;
• increased sweating;
• exophthalmos;
• impaired glucose tolerance.

Because of lack of TSH, especially in childhood, cretinism develops. The child begins to lag behind in psychomotor development, the growth rate slows down, and delayed sexual development is observed.

Adrenocorticotropic hormone affects the function of the adrenal cortex. When overproduced, it causes Cushing's disease.

In addition, they have:

• increased fatigue;
• there is a decrease in intellectual abilities;
• arterial hypertension;
• sexual dysfunction;
• violation of ossification (calcification) of bones.

Important! ACTH deficiency leads to pronounced changes in the body, decreased immunity and impaired carbohydrate metabolism may be observed.

Prolactin, follicle-stimulating and luteinizing hormone are responsible for the synthesis of germ cells in both men and women. Their excess or deficiency leads to the development of infertility, impaired menstrual cycle and erectile dysfunction.

Dysfunction of the neurohypophysis

The posterior lobe of the pituitary gland produces:

• antidiuretic hormone (vasopressin);
• oxytocin.

Hyperfunction of the posterior lobe of the pituitary gland - rare disease, leading to an increase in vasopressin levels. This disease is called Parhon's syndrome. It is characterized by excessive release of salts from the body and water retention. This leads to the development of water intoxication.

Lack of antidiuretic hormone leads to the development of diabetes insipidus.

Associated symptoms are:

• lethargy;
• weakness;
• irritability.

Important! Delayed diagnosis of diabetes insipidus can lead to dehydration and death.

Oxytocin is the main hormone of a pregnant woman. It is he who regulates the beginning labor activity and the strength of contractions. Its excess at the beginning of pregnancy can lead to premature birth, and the disadvantage is late dates- to weakness of labor.

Diagnosis of hyperfunction and hypofunction of the pituitary gland

If a disease associated with dysfunction of the pituitary gland is suspected, the patient is examined and assessed:

• height;
• thyroid gland size;
• abdominal circumference;
• thickness of the fat fold, etc.

The main way to diagnose pituitary gland dysfunction is to study venous blood on the level of certain hormones.

Normal levels of adenohypophysis hormones in an adult.

Auxiliary methods can be:

• general blood analysis;
• general urine analysis;
• blood chemistry;
• X-ray of the hand (when determining bone age child).

If a tumor or hemorrhage is suspected in the pituitary gland, an MRI is performed.

Treatment

Treatment of hyperfunction and hypofunction of the pituitary gland in humans is prescribed by an endocrinologist after diagnosis. Depending on the cause of the disease, treatment can be symptomatic or etiological.

Thus, after removal of a hormone-producing tumor, it is possible complete cure patient (etiological treatment).

Other reasons most often require lifelong replacement symptomatic therapy hormonal medications, as well as nutrition and lifestyle corrections.

Dysfunction of the pituitary gland leads to complex, sometimes global changes in the entire organism, which can result in its death. However modern level medicine allows a person with these diseases to manage normal image life, subject to all requirements and acceptance medicines.

The causes of pituitary hyperfunction can be either congenital or acquired. The disease is always associated with noticeable destruction of the anterior pituitary gland. The hypothalamus secretes mediators that, going down to the pituitary gland, stimulate the formation of FSH and LH (GSIC). Finally, hypofunction of the posterior lobe of the pituitary gland is associated with diabetes insipidus (diabetes insipidus), which is characterized by polyuria (excretion of more than 5 liters of diluted urine per day).

Phenomena similar to human pituitary cachexia can be observed experimentally (in rats) after removal of the pituitary gland. Diabetes insipidus can also occur with tumors and infectious processes based on brain damage diencephalon and its connection with the posterior lobe of the pituitary gland.

Hyperfunction of the pituitary gland is called this pathological process, which is characterized by increased secretion of one or all hormones that are synthesized in this endocrine organ. Clinical manifestations of pituitary hyperfunction depend on the predominance of one or another tropic hormone.

The main place in the diagnosis of pituitary hyperfunction is given to laboratory research. Tests that detect changes in the level of biochemical parameters that are controlled by one or another pituitary hormone.

Treatment of pituitary hyperfunction is based on the use of medications that suppress the production of a particular hormone in the pituitary gland if there is an excess of it. In a relationship primary lesion pituitary gland effective measures there is no prevention. Diet and lifestyle depend on available clinical manifestation hyperfunction of the pituitary gland. Various diseases, arising as a result of hypofunction of the pituitary gland, are united by some common symptoms.

Quite often, pituitary necrosis occurs in women after childbirth, as well as in people with cancerous pituitary tumors. A person becomes ill with it as a result of taking hormonal drugs or due to the treatment of pituitary tumors with various medications.

Hypofunction of the anterior pituitary gland in humans

Successful treatment of the underlying disease causing hypopituitarism may lead to complete or partial restoration normal production of pituitary hormones. If the cause of the disease is a pituitary tumor, the tumor must first be removed surgically, and then hormone replacement therapy begins.

Central diabetes insipidus is a consequence of damage to the pituitary gland or hypothalamus as a result of external influences (trauma, surgery, tumor, disease). Somatotropic hormone (growth hormone, STH). Excessive secretion of this hormone is most often observed with eosinophilic pituitary adenoma.

Hyperfunction of the pituitary gland

Now importance is attached to tumors of the hypothalamus in general, which somehow stimulate the secretion of GTH by the pituitary gland. Overeducation LTG was observed in patients suffering from breast cancer, in whom therapeutic purpose The pituitary stalk was transected.

In pathology, this formation of estrogen can increase, which leads to suppression of the formation of GTH and thereby the development of hypogonadism. Therefore, the pituitary gland seems to consist of two fused parts, having various functions and structure. The growth of the pituitary gland stops at the end of puberty. The formation of the activity of the pituitary gland is associated with the development of the brain. Most important stages are 6–7 years and 10 years, when the production of hormones by the pituitary gland increases significantly.

Diabetes insipidus with damage to the hypothalamic nuclei is more pronounced than with damage to only the posterior lobe of the pituitary gland. Increased blood glucose levels, etc. Drug-related, etc. Somatotropic hormone. The second tests include determining the level of peripheral hormones in the blood and their metabolites.

Primary hyperfunction is spoken of when it is not possible to identify possible reason diseases. Creating a favorable psychological climate, etc. Thus, with increased formation of mineralocorticoids (Itsenko-Cushing's disease and syndrome), it is necessary to limit the consumption of salty foods, regulate water balance etc.

Professional goals: Has great experience ultrasound examinations all organs and systems, including expert level. More than 30 years ago, a scientist named Simmonds described a syndrome associated with extensive destruction of the pituitary gland. IN medical literature this syndrome is known as panhypopituitarism and also known as Sheehan's syndrome, Simmonds' syndrome, and pituitary cachexia. Congenital cases of this disease appear in early childhood.

The structure and location of the pituitary gland

In addition, depending on gender, patients are prescribed appropriate hormones (testosterone, progesterone, estrogen). It is practiced to prescribe gonadotropins when the ability to conceive is restored as a result of earlier hormonal therapy.

Under the influence of a tumor, the pituitary gland can increase in size, shrink or be damaged, and as a result, it is impaired normal process production of hormones. Infiltrative diseases such as sarcoidosis are especially dangerous and increase the risk of hypopituitarism. In this case, it will be impossible to harm the organs and systems of the body. When infertility occurs, patients are given gonadotropins, which stimulate ovulation in women and sperm production in men.

This disease is the body's response to the improper production, storage and release of certain hormones. Diabetes insipidus can happen when a person's kidneys fail to respond properly to hormones. Very rarely, diabetes insipidus can develop during pregnancy - in this case it is called gestational.

Absence timely treatment hyperfunction of the pituitary gland can lead to the development of certain complications. In accordance with the development of the pituitary gland, from two rudiments it is distinguished, as already indicated, the anterior lobe - adenohypophysis, and the posterior lobe - neurohypophysis.

Hypo and hyperfunction of the pituitary gland today is a fairly common phenomenon among people all over the world. There is a disruption in the operation of the secret various reasons. Hyperfunction and hypofunction are such diseases during which the pituitary gland produces too much or too little hormones, which affects the development of the body and its functions.

Hyperfunction of the pituitary gland is a disease in which the gland begins to produce large amounts of hormones. different types. Since the pituitary gland is a primary gland endocrine system, which controls the work of all other secrets, then if its work is disrupted, a malfunction occurs in the body.

Hyperfunction of the pituitary gland involves the production of large amounts of hormones by the gland different types. The pituitary gland can produce the following hormones:

1. Thyroid-stimulating.
2. Prolactin.
3. Self-tropic.

Also, if the gland malfunctions, it can produce large quantities of other hormones.

Causes of pathology

Hyperfunction of the pituitary gland can manifest itself due to two main factors:

1. Congenital.
2. Purchased.

In the first type of pathology, it is transmitted from parents to children at the genetic level. Acquired hyperfunction can be caused by:

• Infectious diseases.
• Head injuries.
• Using medications for a long time.
• Stress.
• Blood flow disorders.
• Autoimmune processes.
• Tumors.

Signs of pathology

Hyperfunction may have different signs. Here everything will depend on which hormone is in excess in the body. Most often, a patient with this diagnosis may experience the following symptoms:

• Muscle weakness.
• Menstrual irregularities.
• Acceleration of metabolic processes.
• Increased blood pressure.
• Infertility.
• Frequent pulse.
• Fatigue. Mental disorders.
• Brittle nails and hair.
• Stretch marks on the skin.

Hyperthyroidism: diagnosis

Pituitary dysfunction is diagnosed when the patient undergoes tests. When examining the material in the laboratory, the specialist initially determines which hormone is in excess in the body. Next, the biochemical indicator of the material is tested.

If the doctor does not have enough data obtained in the laboratory to make a diagnosis, he may prescribe other types of examinations using special equipment. This:

1. X-ray.
2. Tomography.

After precise setting After diagnosing and identifying the causes of dysfunction of the pituitary gland, the doctor prescribes appropriate therapy.

Treatment

If a person notices negative manifestations that happen to him, it is important for him to get checked by a doctor. It is also worth visiting the clinic if the above symptoms are detected. When treatment is not diagnosed in time and treatment does not occur at first, this can cause complications and the manifestation of the following diseases:

• Diabetes.
• Disorders in the reproductive system.
• Violation of salt and water balance.
• Obesity.
• Violation of the structure of blood vessels.
• Osteoporosis.
• Thyrotoxicosis.

If a person has a large amount of hormones in the body that are produced by the adenohypophysis, the doctor will prescribe appropriate therapy. Medicines are prescribed depending on the type of pathology, its severity and general condition person.

Treatment is usually done with medications that can control the pituitary gland's production of hormones. Such medications are prescribed only by a doctor. Throughout the course of treatment, the patient must be constantly monitored by a doctor to monitor the treatment process.

If necessary, the therapy can be changed. The doctor will prescribe other medications. It all depends on the analysis.

It is also important to adhere to a certain diet during the course of treatment. Nutrition should be balanced and rich in vitamins or minerals. The patient should avoid eating large amounts of salty and fatty foods. You need to eat more foods that contain iodine.

Complications of pathology

When a person does not receive timely help when such a disease appears, he may have complications. They are:

• Intoxication.
• Malfunction of the endocrine system.
• Poor absorption of glucose.
• Rapid weight gain.
• Menstrual irregularities.
• Bone fragility.
• Infertility.

Preventive actions

To prevent the manifestation of such a disease, certain preventive measures must be followed. It is worth noting that it is impossible to prevent the congenital type of disease. By maintaining the correct lifestyle, you can only prevent the development of an acquired pathology.

• Avoid head injuries.
• Avoid stress.
• Treat all infectious diseases in a timely manner.
• Follow a diet.
• News The right way life.
• To refuse from bad habits.
• Monitor water and salt balance.
• Not located for a long time in the sun.
• Strengthen the immune system and strengthen the body.
• When the first one appears negative symptoms consult a doctor immediately.

Conclusion

Based on the above, it is clear that hyperfunction of the pituitary gland is quite dangerous disease which requires timely treatment. Therefore, a person should be constantly monitored by a doctor, who can diagnose the pathology in a timely manner.

It is also important to lead healthy image life and follow all doctor’s instructions during treatment. This is the only way to get rid of pathology in a short time, as well as prevent its development.

It is also worth noting that today it is possible to treat hyperfunction using folk remedies. For this you can use herbal decoctions. You can prepare this decoction yourself at home.

Before starting such treatment, mandatory You should consult a doctor who will assess all the risks and give good advice. It is also worth understanding that treatment folk remedies cannot be the main type of therapy.