Case Study 1: The Endocrine System

Case Study 1 – The Endocrine System

Christina D’Amico

University of Saint Joseph

Abstract A fifteen-year-old boy with many hormonal abnormalities starting at the age of eleven suffered from joint pain and swelling along with poor bone growth and development. He broke his left hip and had low levels of testosterone and high levels of growth hormone resulting in gigantism and later acromegaly. He had a pituitary tumor removed, an operation on his knee and metal pins placed in his hips. And his jaw was split into fine pieces in order to be expanded because of the acromegaly.

Doctors Notes
• Swelling of right knee.
• Ulcerated sores on lower left leg.
• Abnormal hormone levels.
• Broken left

Should Dr. Kidd tell Eric that he is probably sterile? Why would he be sterile?
I do believe Dr. Kidd should tell Eric that there is a possibility he may be sterile. Because he is his patient he has the right to know any possible side affects from his previous irregular hormone secretion. Eric has a possibility of being sterile because of the hyposecretion of T4 and T3, which can cause sterility (Marieb & Hoehn, 2013, p.607). Eric might also be sterile because of his low testosterone levels. This causes semen volume to decrease, and it can impair erection and ejaculation, leading to sterility (Marieb & Hoehn, 2013, p.1034).
2. Is there anything that they could try to do to stimulate spermatogenesis? Why is the absence of facial hair important?
One thing the doctors could do to try and stimulate spermatogenesis is to give Eric follicle stimulating hormone (FSH) and luteinizing hormone (LH). The LH will promote testosterone production while the FSH will stimulate sperm production (Marieb & Hoehn, 2013, p.603). The absence of facial hair is important in Eric’s situation to make sure that his body in not producing excess amounts of these hormones. This could cause dysplasia of the anterior pituitary leading to the growth of a tumor (Greco, 2013, Lecture). Because he is not growing facial hair the doctors know that he is not at risk for producing too much hormone and developing a

Why are his kidneys so active at night?
Eric’s constant urination throughout the night led the doctor to discover that he had diabetes insipidus. This frequent urination throughout the night indicates that he is unable to maintain water balance i.e. an insufficient amount of antidiuretic hormone is present (Marieb & Hoehn, 2013, p.602).
2. Eric’s unpredictable shock responses could be due to his low levels of adrenocorticotropic hormone (ACTH). Low levels of this hormone can cause him to act abnormally to stressors. The low levels of ACTH are due to the prevention of corticotrophin releasing hormone (CRH) from rising levels of cortisol that are being secreted into the blood (Marieb & Hoehn, 2013, p.614).
3. If the pituitary is so important, and if Eric is not getting replacements of hormones the pituitary makes (except for ADH), why isn’t he dead?
Eric is not dead because although binding of a hormone to a receptor is important it is also dependent on the number of receptors available for the hormone to bind to on the target cell. If there are still messages being received by the target cell than the hormones are still able to bind to a receptor (Marieb & Hoehn, 2013,