Endocrine disorders

 

Result from hypo or hyper secretion of a particular hormone

 

Posterior pituitary

Hyposecretion of ADH - diabetes insipidus

 

Anterior pituitary

Hypo growth hormone,

childhood - dwarf

 

Hyper growth hormone,

child     - giant

adult     - acromegaly

 

Acromegaly

Excess growth hormone from a pituitary tumour, usually a macroadenoma

 

Clinical features

Headache

Sweating

Skull, jaw, hands and feet growth

Cardiomyopathy, skeletal muscle myopathy, hepatomegaly

Increased sweating

Hypertension

Cardiovascular disease, DM 2 (caused by insulin resistance), colon cancer all more common

 

Treatments

1. Surgery

2. Radiotherapy

3. Medical options

 

 

Phaeochromocytoma

 

A tumour of chromaffin cells, usually of the adrenal medulla, 10% are malignant, 10%familial, 10% extra-adrenal in sympathetic chain

 

Clinical features

Paroxysmal hypertension

Postural hypotension, (after pressure natriuresis)

Paroxysms of pallor, palpitations, sweating, headache, severe anxiety, abdominal pain, vomiting, constipation, weight loss, glucose intolerance

 

Investigations

Serum and urine catecholamines (with risk of false negatives)

CT or MRI

 

Management

Medical stabilization followed by surgical removal