Clinical Case Study
A Patient with Persistent Lactation and Recurrent Hypercalcemia
Ryan Alberth Kintana
National University
CLS301 Clinical Biochemistry
Background
An overweight adolescent patient with constant bilateral lactation, diagnose with Hyperprolactinemia resulting elevated serum prolactin.
Methods
Patients go through a surgery performed through the nose and sphenoid sinus to extract the pituitary tumors. Then later develop a condition of absent production of the anterior pituitary hormones, with lack of vasopressin causing excessive production of very dilute urine, commonly result problems that influence the pituitary gland either decrease or remove its function or interfere with hypothalamic discharge of the varying pituitary-releasing
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Body has four parathyroid glands situated in the neck controlling the body's calcium levels. The parathyroids discharge it into the bloodstream a substance called parathyroid hormone by which it preserve the normal delivery of calcium in the blood, bones, and urine. In the symptoms stated above the parathyroid glands be likely to be overactive resulting to hyperparathyroidism. Parathyroid glands are associated forming tumors that release PTH primarily to excess calcium in the blood. Hypercalcemia result to High blood that can exist for many years. Hypercalcemia cause excessive calcium to discharge into the urine resulting to after effect of kidney stones or kidney damage as well with bones to lose calcium. Disorder can frequently be noticed during adolescence period. Hyperparathyroidism could cause no problems or un notice for many years, or possibly it may cause weakness, bone pain, indigestion, kidney stones, or thinning of bones. Based on the study the usual treatment is an operation to remove most or all of the parathyroid glands, to remove the three largest glands and all but a small part of the fourth, a further is to remove all glands and at the same time transplant a small part of one gland into the forearm similarly on the parathyroidectomy with left forearm autograft and total thyroidectomy. By maintaining a fraction of one gland, the parathyroid transplant carry on to discharge PTH …show more content…
Excessive prolactin levels result to excessive production of breast milk or obstruct with fertility.
Should treatment is required medication as a dopamine agonist can efficiently contract the tumor and lower the production of prolactin. Infrequently, prolactinomas do not react well to the medication in such cases, possible surgery, exposing radiation, or both may be required.
After a few years, there was a tumor in her pituitary region. The tumor was secreting excessive amounts of growth hormone, casing symptoms to appear. She had enlarged hands and feet, coarsened, enlarged facial features, coarse, oily, thickened skin, and
Surgery provides the most rapid recovery than anti-thyroid drugs (ATD) that has to be taking for a long time, and the RAI in which it has to be use for a long time before it takes effect (Schussler-fiorenza et al., 2006). Surgery is recommended in the treatment of GD in pregnant women if the following occurs: 1. Patient do not complied with the medical
There are two types of calcium deficiency. Dietary calcium deficiency is caused by inadequate calcium intake, which can lead to depleted calcium stores in the bones, thinning and weakening of the bones, osteopenia and osteoporosis. Hypocalcemia is a low level of calcium in the blood that can occur from taking medications, medical treatments or diseases, such as renal failure or rickets. Many published studies show that low calcium intake throughout life is associated with low bone mass and high fracture rates, in addition to hypertension and cardiac arrhythmias. Other associate signs and symptoms include muscle spasms, tingling,
Central Diabetes Insipidus is caused by a lack the Antidiuretic Hormone (ADH) or Vasopressin produced by the hypothalamus and secreted by the posterior pituitary gland. ADH is responsible for the amount of water excreted by the kidneys. If ADH is low or not being secreted then the kidneys do not function properly and excrete too much water. This is why it is termed Central Diabetes Insipidus, because the problem lies in the pituitary gland and not in the kidneys which is termed nephrogenic diabetes insipidus. Dr. Lee should prescribe the hormone Vasopressin (Desmopressin or DDAVP) which can be given by nose spray, injections or tablets.
story of living with Cushing’s Disease: https://csrf.net/patient-stories/ashley-c-transsphenoidal-pituitary-surgery/ Test and Diagnostics: Cushing’s disease can be hard to diagnose because it has a lot of the signs and symptoms of other diseases. Frist your doctor will conduct a physical exam if suspected of having Cushing’s doctor will look for rounding of the face “moon face”, or a pad of fatty tissue between the shoulder “buffalo hump” the next step will be taken. Urine and blood test – Will measure the hormone levels in your urine and blood to tell whether you’re your body is producing excessive amounts of cortisol. For a urine test your doctor might recommend a 24 hour urine collection. Then both urine and blood test will be sent to the laboratory to be tested to check cortisol levels.
• Blood and urine tests to check whether the levels of calcium and alkaline phosphatase are higher than normal. These substances may increase with abnormal bone growth. • Imaging studies, such as X-rays and bone scans. TREATMENT Treatment for this condition depends on symptoms and the area of the body that is affected. Treatment may not be needed if you do not have symptoms.
Cushing’s Syndrome is a disease that involves an excess of the Adrenocorticotropic hormone (ACTH) from the pituitary gland, most likely because of cancerous cells (Helm). This causes an excess of cortisol to be made in the adrenal gland which creates the symptoms known as Cushing’s Syndrome. This can also be caused by a tumor on the adrenal gland which causes an overproduction of cortisol (Helm). Cortisol is a steroid hormone which helps regulate blood sugar as well as aid in the metabolism of protein, fat, and carbohydrates.
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
3. I spent my young life struggling with this disease and my symptoms, my grandmother started having symptoms later in life around her 40’s. C. Possible environmental factors are also being studied. 1. For example, researchers have found that consuming too much iodine may inhibit thyroid hormone production in susceptible individuals.
5. If the pituitary is so important, and Eric is not getting replacements of hormones the pituitary makes (except for the one from question 4 above), why isn’t he dead? To answer this question think through the cascade of events from the hypothalamus to effect. You will need to think about homeostatic feedback loops and the regulations of hormones. Before we can discuss why Eric is alive without a functioning pituitary gland we must first understand how the pituitary gland functions within the endocrine system.
CASE: John Smith is an 11 year old Asian boy with PMHx of hypothyroidism x 2 years, on levothyroxine 25 mcg daily presented with painful progressively enlarging goiter that started 2 months ago. The pain is described as constant shooting and radiating to the neck, rated 6/10, nothing made it better, moving his neck made it worse. Pt states that the pain is mostly localized to the right, and it is associated with compressive symptoms like difficulty breathing and swallowing, but no change in voice. The swelling was painful and progressive and at the time of examination was 2 × 2 cm on the right side of the neck and was moving with deglutition. She had no other complaints and her family history was noncontributory.
Molecular genetics have shown nearly all to be monoclonal, suggesting that an intrinsic pituitary defect is likely to be responsible for pituitary tumorigenesis. Occasionally, prolactinoma may be part of a multiple endocrine neoplasia syndrome (MEN-1), but this occurs too infrequently to justify MEN-1 screening in every patient with a prolactinoma. • GH- and PRL-secreting adenomas (or mammosomatotroph adenomas) Mixed growth hormone (GH)- and PRL-secreting tumors are well recognized and give rise to acromegaly in association with hyperprolactinemia.
Material and Methods: 40 subjects were divided into two groups of normal healthy individual ( 20 in numbers ) as Group I and hypothyroidism patients ( 20 in numbers) as Group l l from dental outpatient department of Saveetha Dental College and Hospitals. Blood samples were collected from the participants and it was distributed in plain collection tube and centrifuged in 2500 rpm for 10 minutes. The Serum was
These glands together make up what is known as the endocrine system, whose control and command centers are the pituitary gland and hypothalamus. Other endocrine glands are the endocrine pancreas, pineal, adrenal, thyroid and parathyroid glands. Specialists who conduct surgery on these glands are called endocrine surgeons. Hypothalamus and pituitary gland Hamartomas, although rare, are non-neoplastic tumors that arise in the hypothalamus and cause devastating consequences, such as seizures, cognitive impairment, behavioral and emotional troubles, hormonal imbalances and early puberty.
These tumors can vary in how it affects the body because some tumors do not produce hormone while others do (National Cancer Institute, 2015). Most adrenal cancers are not the result of cancer in the adrenal glands; the cancer usually results from metastasized cancer- cancer from another place in the body (National Cancer Institute, 2015). Symptoms can include pain in abdomen depending on tumor size, loss of weight, and weakness if the tumor is not releasing hormones, but if it does it can cause high blood pressure, diabetes, and bone weakening (Bellenir, 2007). Adrenocortical Carcinoma can disturb the sex hormones leading to swollen and tender breast, swelling of the sex organs, and the growth of facial hair (Bellenir, 2007). Due to how rare Adrenal Cortex cancer is the statistics available are not exact; however, it is estimated 300 to 500 people are diagnosed with this form of cancer per year in the United States (University of Michigan Comprehensive Cancer Center, 2012).