CLINICAL MANIFESTATIONS OF ADRENOCORTICOTROPIN DEFICIENCY Part of “CHAPTER 14 – ADRENOCORTICOTROPIN: PHYSIOLOGY AND CLINICAL ASPECTS“ A number of pituitary pathologies can lead to ACTH deficiency, including pituitary tumor, autoimmune lymphocytic…
CLINICAL MANIFESTATIONS OF DISORDERS OF ADRENOCORTICOTROPIN EXCESS Part of “CHAPTER 14 – ADRENOCORTICOTROPIN: PHYSIOLOGY AND CLINICAL ASPECTS“ Hyperpigmentation is common when ACTH levels exceed 300 pg/mL (Fig. 14-4). The highest…
DYNAMIC TESTING OF ADRENOCORTICOTROPIN SECRETORY FUNCTION Part of “CHAPTER 14 – ADRENOCORTICOTROPIN: PHYSIOLOGY AND CLINICAL ASPECTS“ In states of possible autonomous ACTH hypersecretion, dexamethasone is used to inhibit ACTH secretion,…
FUNCTIONS OF ADRENOCORTICOTROPIN Part of “CHAPTER 14 – ADRENOCORTICOTROPIN: PHYSIOLOGY AND CLINICAL ASPECTS“ The primary action of ACTH is to promote steroidogenesis—that is, to enhance the synthesis and secretion of…
SYNTHESIS AND PROCESSING OF PROOPIOMELANOCORTIN Part of “CHAPTER 14 – ADRENOCORTICOTROPIN: PHYSIOLOGY AND CLINICAL ASPECTS“ When ACTH is synthesized in the anterior pituitary gland by the corticotropes, it is derived…
ADRENOCORTICOTROPIN: PHYSIOLOGY AND CLINICAL ASPECTS David J. Torpy Richard V. Jackson The existence of an adrenocorticotropic factor was predicted by classic pituitary ablation/pituitary extract replacement experiments.1,2 Ovine and human adrenocorticotropin…
PREGNANCY AND PROLACTINOMAS Part of “CHAPTER 13 – PROLACTIN AND ITS DISORDERS“ Many women with hyperprolactinemia present with infertility; bromocriptine is typically used to normalize prolactin levels and allow normal…
MANAGEMENT OF MACROPROLACTINOMAS Part of “CHAPTER 13 – PROLACTIN AND ITS DISORDERS“ Unlike patients with microprolactinomas, those with macropro-lactinomas always require therapy. Patients with macroade-nomas may have evidence of local…
TREATMENT FOR PROLACTINOMAS Part of “CHAPTER 13 – PROLACTIN AND ITS DISORDERS“ Treatment depends on whether the patient has hyperpro-lactinemia due to an underlying cause such as drugs or hypothyroidism,…
DIFFERENTIAL DIAGNOSIS AND CLINICAL APPROACH TO HYPERPROLACTINEMIA Part of “CHAPTER 13 – PROLACTIN AND ITS DISORDERS“ As shown in Table 13-1 and Table 13-2, hyperprolactinemia has multiple causes. The measurement…
