Pituitary hormone excess
Last updated: Saturday, 22, January, 2011
| Causes | Appropriate Tests |
|---|---|
Increased levels of pituitary hormones may be the result of autonomous production by pituitary adenomas, release from inhibitory feedback mechanisms, or ectopic secretion. One or more hormones may be increased and if there is a pituitary lesion, there may be associated deficiency of one or more hormones. See also Pituitary/hypothalamic disorders. | |
ADH excess | See SIADH |
Growth hormone excess | Acromegaly, gigantism (in childhood). IGF-I; growth hormone suppression test. |
Pituitary adenoma | |
Ectopic syndromes (rare) | |
Pancreatic islet cell tumour | See under Pancreatic neoplasm |
Carcinoid tumour (lungs, adrenals) | |
Adrenocorticotrophin excess | Dexamethasone suppression test (overnight); cortisol (free) - urine. Then, if indicated, dexamethasone suppression test (long) including ACTH. See Cushing's syndrome |
Pituitary adenoma | Cushing's disease. |
Ectopic ACTH syndrome | Patients may have clinical features of Cushing's syndrome. |
Nelson's syndrome | Patients are not Cushingoid. ACTH is the appropriate test. |
Prolactin excess | Present with amenorrhoea and/or galactorrhoea. Prolactin; repeat, if elevated, to document persistent elevation. See also Infertility |
Prolactinoma | |
Other pituitary tumour | |
Physiological
| |
Drugs, especially
| |
Thyrotrophin excess | 'Pituitary' Hyperthyroidism: TSH, thyroxine (free). See Hyperthyroidism |
Pituitary adenoma | |
Pituitary T4 resistance | |
Gonadotrophin excess | Precocious puberty, Gynaecomastia. In many cases, there are no clinical features suggesting an endocrine disorder. LH, FSH, alpha subunit, testosterone or oestradiol. |
Pituitary adenoma | |
Ectopic syndromes, especially
| Human chorionic gonadotrophin (beta subunit). |
Alpha subunit excess | These patients do not present with clinical features of an endocrine disorder: alpha subunit. |
Alpha subunit secreting tumours |