Lymphocytic adenohypophysitis: a pituitary mass lesion occurring during pregnancy. Proposal for medical treatment

Article Abstract:

The pituitary gland is a small but very important gland located in the brain. It is responsible for making several different hormones that are necessary for normal growth and reproduction. Lymphocytic adenohypophysitis is a disorder that causes the pituitary gland to increase in size and interferes with the function of the pituitary gland. If this condition is not treated, it can result in death. There have been only 50 reported cases of this disease in the world; 48 cases have occurred in women, and most were diagnosed during or soon after pregnancy. This condition can be difficult to diagnose and it is often mistaken for a tumor (adenoma). Treatment includes a combination of brain surgery and hormone treatments. This article describes the case reports of two pregnant women who developed lymphocytic adenohypophysitis. One woman was diagnosed six weeks before child birth; the condition was detected in the other woman one month after child birth. The first symptoms were headache and blurred vision. Blood tests were performed and showed a deficiency of pituitary hormones. Computed tomography (CT) scans of the brain were performed and showed that the pituitary gland was very large. In one case, surgery was performed to remove a large, hard mass from the brain. Following surgery, the patient was treated with hydrocortisone, desmopressin, levothyroxine, estrogen, and medroxyprogesterone. The patient's vision improved and the patient was discharged from the hospital. In the second case, the patient was treated with prednisone beginning two weeks prior to child birth. The patient's vision returned to normal by itself one week after child birth. A second CT scan was performed and it showed that the pituitary gland had decreased in size. The patient was discharged form the hospital and is being treated with prednisone. When symptoms of blurred vision and lack of menstruation and lactation (production of breast milk) occur following child birth, the mother should be examined for lymphocytic adenohypophysitis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Abnormalities, Causes of, Pregnancy, Complications of, Pregnancy complications, Pituitary gland, Hypopituitarism, Adenohypophysis, Anterior pituitary gland

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Neuromodulatory regulation of gonadotropin-releasing hormone pulsatile discharge in women

Article Abstract:

Gonadotropin (luteinizing hormone, LH) is a chemical secreted by the pituitary gland that stimulates the sex organs (gonads) to produce eggs or sperm; its own secretion is controlled by gonadotropin-releasing hormone (GnRH or LHRH), manufactured in the hypothalamus (a part of the brain). Part 2 of the November 1990 issue of the American Journal of Obstetrics and Gynecology presents papers from a symposium devoted to pulsatile GnRH, a method of hormone delivery that makes it possible to treat a variety of clinical disorders associated with ovarian dysfunction. A discussion is presented of substances in the body that appear to influence LH pulsatility; the triggering event, pulsatile GnRH release, is affected by other hormones, peptides, and environmental factors. These include the opioid peptides, such as beta-endorphin, which inhibit pulsatile GnRH and LH. Stress causes levels of corticotropin-releasing factor to rise, a substance that stimulates the secretion of adrenocorticotropic hormone (ACTH) and beta-endorphin. These, in turn, inhibit pulsatile LH release, a possible mechanism associated with stress-induced amenorrhea (lack of menstruation). The role of opioid antagonists in LH secretion at different points in the menstrual cycle is also discussed. Dopamine, a neurotransmitter (which mediates the firing of nerve cells), may be part of a feedback loop between opioids and catecholamines (the chemical group of which dopamine is a member); gonadal steroids (estrogens, progesterone, and androgens) may also interact with opioid systems to affect GnRH effects on the pituitary. A review of the medical literature is presented to support these claims. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Physiological aspects, Central nervous system, Control, Gonadotropin releasing hormone, Gonadorelin, Pituitary hormones

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Magnetic resonance imaging in an experimental model of human ovarian cancer demonstrating altered microvascular permeability after inhibition of vascular endothelial growth factor

Article Abstract:

An antibody against vascular endothelial growth factor may reduce the amount of fluid in the abdomen of women with ovarian cancer, according to a study in rats. The antibody prevents the blood vessels from losing proteins, which draw water into the abdomen by osmosis.

Health aspects, Research, Prevention, Ovarian cancer, Ascites, Antibodies

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