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Hypothalamic-Pituitary Disorders. IN: Camacho, P.M.; Gharib, H.; Sizemore, G.W., eds. Evidence-Based Endocrinology. 2nd ed. Philadelphia, PA: Lippincott Williams and Wilkins. 2007. pp 1-29.

This chapter on hypothalamic-pituitary disorders is from a concise, reference-based handbook that is intended to help busy clinicians with endocrine-related diagnostic and therapeutic decisions required in their practices. Using a modification of the McMaster criteria, the contributors to the text have critically assessed and graded studies, assisting readers in quickly evaluating the articles that have led to practice recommendations. Topics covered in this chapter include evaluation of the hypothalamic-pituitary axis, imaging of the hypothalamic-pituitary system, pituitary tumors, hypopituitarism, disorders of the prolactin system, acromegaly, Cushing disease, diabetes insipidus, and the syndrome of inappropriate antidiuretic hormone secretion. For each disease state included, the authors discuss etiology, epidemiology, pathophysiology, diagnosis, and treatment considerations. The chapter includes an outline and an extensive, annotated list of references. 3 tables. 78 references.

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Hypothalamus and Pituitary Gland. IN: Gardner, D.; Shoback, D., eds. Greenspan’s Basic and Clinical Endocrinology. 8th ed. Columbus, OH: McGraw Hill. 2007. pp 101-156.

This chapter about evidence-based endocrinology and clinical epidemiology is from a textbook about endocrinology that describes the scientific principles and clinical management of patients with endocrine-related diseases and disorders. The authors review the normal functions of the pituitary gland, the neuroendocrine control mechanisms of the hypothalamus, and the disorders of those mechanisms. They discuss hypothalamic hormones, anterior pituitary hormones, endocrinologic evaluation of the hypothalamic-pituitary axis, and pituitary and hypothalamic disorders. Specific topics include adrenocorticotropic hormone (ACTH) and related peptides, growth hormone (GH), prolactin, thyrotropin, gonadotropins, evaluation of ACTH, problems in the evaluation of the hypothalamic-pituitary axis, the effects of pharmacologic agents on hypothalamic-pituitary function, endocrine tests of hypothalamic-pituitary function, empty sella syndrome, hypothalamic dysfunction, hypopituitarism, and pituitary adenomas. The chapter includes numerous black-and-white photographs and illustrations; a list of abbreviations is provided. 18 figures. 12 tables. 90 references.

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Disorders of the Anterior Pituitary And Hypothalamus. IN: Jameson, J.L., ed. Harrison's Endocrinology. Columbus, OH: McGraw Hill. 2006. pp 17-56.

This chapter on disorders of the anterior pituitary and hypothalamus glands is from a textbook that offers a comprehensive, practical look at the field of endocrinology. The anterior pituitary, together with the hypothalamus gland, orchestrates the complex regulatory functions of many other endocrine glands through the production of six major hormones: prolactin, growth hormone, adrenocorticotropin hormone, luteinizing hormone, follicle-stimulating hormone, and thyroid-stimulating hormone. The authors review the anatomy and development of these glands and discuss hypothalamic and anterior pituitary insufficiency; hypothalamic, pituitary and other sellar masses; prolactin; growth hormone; adrenocorticotropin hormone; the gonadotropins; and thyroid-stimulating hormone. Each section covers the synthesis, secretion, action, and related diseases of the hormone under discussion. The chapter includes full-color illustrations and photographs. 11 figures. 12 tables. 16 references.

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Prolactinoma. Bethesda, MD: National Endocrine and Metabolic Diseases Information Service. 2008. 10 p.

This fact sheet provides information about prolactinoma, a benign—that is, noncancerous—tumor of the pituitary gland that produces a hormone called prolactin. Prolactin stimulates the breast to produce milk during pregnancy. The fact sheet answers common questions about prolactinoma, including how common the condition is, the symptoms and causes of prolactinoma, diagnostic tests that may be used to confirm the presence of prolactinoma, treatment strategies, how prolactinoma affects pregnancy, the impact of oral contraceptives and hormone replacement therapy (HRT) on prolactinoma, and the risk of osteoporosis in women with high prolactin levels. In women, high levels of prolactin in the blood often cause infertility and changes in menstruation. Women who are not pregnant or nursing may begin producing breast milk. In men, the most common symptom of prolactinoma is erectile dysfunction. Prolactinoma is diagnosed through a blood test. Magnetic resonance imaging (MRI) may be used to detect pituitary tumors and determine their size. The first line of treatment is medication to shrink the tumor and return prolactin levels to normal. Sometimes surgery or radiation may be necessary. Women with prolactinoma should be carefully evaluated before becoming pregnant and monitored during pregnancy by an endocrinologist. The fact sheet concludes with a brief section describing current research efforts in this area. Readers are referred to three organizations for more information: the American Association of Clinical Endocrinologists at www.aace.com or 904–353–7878, the Endocrine Society at www.endo-society.org or 1–888–363–6274, and the Pituitary Society at www.pituitarysociety.org or 212–263–6772. The fact sheet includes the contact information and a brief description of the goals and activities of the National Endocrine and Metabolic Diseases Information Service.

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