Systemic illness.

Pituitary
Marta BondanelliEttore C degli Uberti

Abstract

Systemic illnesses are associated with alterations in the hypothalamic-pituitary-peripheral hormone axes, which represent part of the adaptive response to stressful events and may be influenced by type and severity of illness and/or pharmacological therapy. The pituitary gland responds to an acute stressful event with two secretory patterns: adrenocorticotropin (ACTH), prolactin (PRL) and growth hormone (GH) levels increase, while luteinizing hormone (LH), follicle-stimulating hormone (FSH) and thyrotropin (TSH) levels may either decrease or remain unchanged, associated with a decreased activity of their target organ. In protracted critical illness, there is a uniformly reduced pulsatile secretion of ACTH, TSH, LH, PRL and GH, causing a reduction in serum levels of the respective target-hormones. These adaptations are initially protective; however, if inadequate or excessive they may be dangerous and may contribute to the high morbidity and mortality risk of these patients. There is no consensus regarding the type of approach, as well as the criteria to use to define pituitary axis function in critically ill patients. We here provide a critical approach to pituitary axis evaluation during systemic illness.

References

Feb 1, 1978·Archives of Internal Medicine·G RamirezW Jubiz
Dec 1, 1976·The Journal of Clinical Endocrinology and Metabolism·V S Lim, V S Fang
Jun 1, 1975·The Journal of Clinical Investigation·I J ChopraD A Fisher
Nov 1, 1975·The Journal of Clinical Endocrinology and Metabolism·I J ChopraD H Solomon
Jan 1, 1992·Digestive Diseases·S Møller, U Becker
Nov 1, 1991·The Journal of Clinical Endocrinology and Metabolism·C F LimJ R Stockigt
Feb 1, 1990·The Journal of Clinical Endocrinology and Metabolism·C A SpencerJ T Nicoloff
Aug 1, 1990·Alcoholism, Clinical and Experimental Research·S SaxenaJ Wimalasena
Mar 1, 1990·The Journal of Clinical Endocrinology and Metabolism·J A MerenichG S Kidd
Dec 1, 1990·The Journal of Clinical Endocrinology and Metabolism·T van der PollH P Sauerwein
Jun 15, 1989·Annals of Internal Medicine·J S LoPrestiJ T Nicoloff
Apr 16, 1988·Lancet·F BricaireA G Saimot
Jul 1, 1986·The Journal of Clinical Endocrinology and Metabolism·G A Brent, J M Hershman
Jan 1, 1986·Psychotherapy and Psychosomatics·H TamaiS Nagataki
Aug 1, 1988·Clinical Endocrinology·J D ClarkO M Edwards
Mar 1, 1988·The American Journal of Medicine·A S DobsB F Polk
Jul 1, 1987·Archives of Internal Medicine·B ChernowJ R Fletcher
Mar 1, 1985·The Journal of Clinical Endocrinology and Metabolism·P D WoolfM Kelly
Apr 1, 1986·The Journal of Clinical Investigation·R UdelsmanG P Chrousos
Dec 1, 1972·The Journal of Clinical Endocrinology and Metabolism·G L NoelA G Frantz
Jun 1, 1972·The Journal of Clinical Endocrinology and Metabolism·S W Spaulding, R I Gregerman
Apr 1, 1983·Clinical Endocrinology·M J WheelerC N Chen
Apr 1, 1980·The American Journal of Medicine·F GómezT Lemarchand-Béraud
Oct 1, 1981·The Journal of Clinical Endocrinology and Metabolism·E M KapteinJ T Nicoloff
Jan 1, 1982·The American Journal of Medicine·M M KaplanJ E Haddow
Dec 21, 1995·The New England Journal of Medicine·M I Surks, R Sievert
Dec 15, 1995·Annals of Internal Medicine·G BouachourM P Guiraud
Jan 1, 1993·Hormone Research·J BenthamR J Ross
Jan 1, 1995·Intensive Care Medicine·G BouachourP Alquier
Jul 1, 1995·Metabolism: Clinical and Experimental·L PoretskyB Zumoff
May 1, 1994·The Journal of Urology·S MadersbacherU Maier

❮ Previous
Next ❯

Citations

Oct 25, 2011·QJM : Monthly Journal of the Association of Physicians·A C PhillipsG D Batty
Feb 5, 2011·Critical Care : the Official Journal of the Critical Care Forum·Tarek SharsharUNKNOWN Groupe de Réflexion et d'Etude des Neuromyopathies En Réanimation
Apr 25, 2013·Growth Hormone & IGF Research : Official Journal of the Growth Hormone Research Society and the International IGF Research Society·Chrysoula PapastathiSpyros Zakynthinos
Mar 25, 2010·Intensive Care Medicine·Tarek SharsharKathleen Laborde
Apr 30, 2010·The Journal of Clinical Endocrinology and Metabolism·Aristotelis TsiakalosGregory Kaltsas

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.