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Archive for the ‘Hypopituitarism’ Category

OMIM Entry – # 146510 – PALLISTER-HALL SYNDROME; PHS

Biesecker, L. G., Abbott, M., Allen, J., Clericuzio, C., Feuillan, P., Graham, J. M., Jr., Hall, J., Kang, S., Olney, A. H., Lefton, D., Neri, G., Peters, K., Verloes, A. Report from the workshop on Pallister-Hall syndrome and related phenotypes. Am. J. Med. Genet. 65: 76-81, 1996. [PubMed: 8914745] [Full Text: http://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0148-7299&date=1996&volume=65&issue=1&spage=76%5D

Biesecker, L. G., Kang, S., Schaffer, A. A., Abbott, M., Kelley, R. I., Allen, J. C., Clericuzio, C., Grebe, T., Olney, A., Graham, J. M., Jr. Exclusion of candidate loci and cholesterol biosynthetic abnormalities in familial Pallister-Hall syndrome. J. Med. Genet. 33: 947-951, 1996. [PubMed: 8950676] [Full Text: http://jmg.bmj.com/cgi/pmidlookup?view=long&pmid=8950676%5D

Clarren, S. K., Alvord, E. C., Jr., Hall, J. G. Congenital hypothalamic hamartoblastoma, hypopituitarism, imperforate anus, and postaxial polydactyly–a new syndrome? Part II: neuropathological considerations. Am. J. Med. Genet. 7: 75-83, 1980. [PubMed: 7211954] [Full Text: http://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0148-7299&date=1980&volume=7&issue=1&spage=75%5D

Demurger, F., Ichkou, A., Mougou-Zerelli, S., Le Merrer, M., Goudefroye, G., Delezoide, A.-L., Quelin, C., Manouvrier, S., Baujat, G., Fradin, M., Pasquier, L., Megarbane, A., and 40 others. New insights into genotype-phenotype correlation for GLI3 mutations. Europ. J. Hum. Genet. 23: 92-102, 2015. [PubMed: 24736735] [Full Text: https://dx.doi.org/10.1038/ejhg.2014.62%5D

Donnai, D., Burn, J., Hughes, H. Smith-Lemli-Opitz syndromes: do they include the Pallister-Hall syndrome? (Letter) Am. J. Med. Genet. 28: 741-743, 1987. [PubMed: 3425639] [Full Text: http://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0148-7299&date=1987&volume=28&issue=3&spage=741%5D

Finnigan, D. P., Clarren, S. K., Haas, J. E. Extending the Pallister-Hall syndrome to include other central nervous system malformations. Am. J. Med. Genet. 40: 395-400, 1991. [PubMed: 1746599] [Full Text: http://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0148-7299&date=1991&volume=40&issue=4&spage=395%5D

Galasso, C., Scire, G., Fabbri, F., Spadoni, G. L., Killoran, C. E., Biesecker, L. G., Boscherini, B. Long-term treatment with growth hormone improves final height in a patient with Pallister-Hall syndrome. Am. J. Med. Genet. 99: 128-131, 2001. [PubMed: 11241471] [Full Text: http://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0148-7299&date=2001&volume=99&issue=2&spage=128%5D

Graham, J. M., Perl, D., O’Keefe, T., Rawnsley, E., Little, G. A. Apparent familial recurrence of hypothalamic hamartoblastoma syndrome. (Abstract) Proc. Greenwood Genet. Center 2: 117-118, 1983.

Hall, J. G., Pallister, P. D., Clarren, S. K., Beckwith, J. B., Wiglesworth, F. W., Fraser, F. C., Cho, S., Benke, P. J., Reed, S. D. Congenital hypothalamic hamartoblastoma, hypopituitarism, imperforate anus, and postaxial polydactyly–a new syndrome? Part I: clinical, causal, and pathogenetic considerations. Am. J. Med. Genet. 7: 47-74, 1980. [PubMed: 7211952] [Full Text: http://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0148-7299&date=1980&volume=7&issue=1&spage=47%5D

Huff, D. S., Fernandes, M. Two cases of congenital hypothalamic hamartoblastoma, polydactyly, and other congenital anomalies (Pallister-Hall syndrome). (Letter) New Eng. J. Med. 306: 430-431, 1982. [PubMed: 7057839] [Full Text: http://www.nejm.org/doi/abs/10.1056/NEJM198202183060719?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed%5D

Iafolla, K., Fratkin, J. D., Spiegel, P. K., Cohen, M. M., Jr., Graham, J. M., Jr. Case report and delineation of the congenital hypothalamic hamartoblastoma syndrome (Pallister-Hall syndrome). Am. J. Med. Genet. 33: 489-499, 1989. [PubMed: 2688416] [Full Text: http://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0148-7299&date=1989&volume=33&issue=4&spage=489%5D

Johnston, J. J., Olivos-Glander, I., Killoran, C., Elson, E., Turner, J. T., Peters, K. F., Abbott, M. H., Aughton, D. J., Aylsworth, A. S., Bamshad, M. J., Booth, C., Curry, C. J., and 36 others. Molecular and clinical analyses of Greig cephalopolysyndactyly and Pallister-Hall syndromes: robust phenotype prediction from the type and position of GLI3 mutations. Am. J. Hum. Genet. 76: 609-622, 2005. [PubMed: 15739154] [Full Text: https://linkinghub.elsevier.com/retrieve/pii/S0002-9297(07)62872-9%5D

Kang, S., Allen, J., Graham, J. M., Jr., Grebe, T., Clericuzio, C., Patronas, N., Ondrey, F., Green, E., Schaffer, A., Abbott, M., Biesecker, L. G. Linkage mapping and phenotypic analysis of autosomal dominant Pallister-Hall syndrome. J. Med. Genet. 34: 441-446, 1997. [PubMed: 9192261] [Full Text: http://jmg.bmj.com/cgi/pmidlookup?view=long&pmid=9192261%5D

Kang, S., Graham, J. M., Jr., Abbott, M., Schaffer, A., Green, E. D., Rosenberg, M., Allen, J., Clericuzio, C., Grebe, T., Haskins-Olney, A., Biesecker, L. G. Autosomal dominant Pallister-Hall syndrome maps to 7p13. (Abstract) Am. J. Hum. Genet. 59 (suppl.): A17 only, 1996.

Kang, S., Graham, J. M., Jr., Olney, A. H., Biesecker, L. G. GLI3 frameshift mutations cause autosomal dominant Pallister-Hall syndrome. Nature Genet. 15: 266-268, 1997. [PubMed: 9054938] [Full Text: https://dx.doi.org/10.1038/ng0397-266%5D

Killoran, C. E., Abbott, M., McKusick, V. A., Biesecker, L. G. Overlap of PIV syndrome, VACTERL and Pallister-Hall syndrome: clinical and molecular analysis. Clin. Genet. 58: 28-30, 2000. [PubMed: 10945658] [Full Text: http://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0009-9163&date=2000&volume=58&issue=1&spage=28%5D

Kletter, G. B., Biesecker, L. G. Male-to-male transmission of the Pallister-Hall syndrome. (Abstract) Am. J. Hum. Genet. 51 (suppl.): A100 only, 1992.

Kuller, J. A., Cox, V. A., Schonberg, S. A., Golabi, M. Pallister-Hall syndrome associated with an unbalanced chromosome translocation. Am. J. Med. Genet. 43: 647-650, 1992. [PubMed: 1605268] [Full Text: http://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0148-7299&date=1992&volume=43&issue=3&spage=647%5D

Low, M., Moringlane, J. R., Reif, J., Barbier, D., Beige, G., Kolles, H., Kujat, C., Zang, K. D., Henn, W. Polysyndactyly and asymptomatic hypothalamic hamartoma in mother and son: a variant of Pallister-Hall syndrome. Clin. Genet. 48: 209-212, 1995. [PubMed: 8591673] [Full Text: http://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0009-9163&date=1995&volume=48&issue=4&spage=209%5D

Lurie, I. W. Pallister-Hall and McKusick-Kaufmann syndromes. (Letter) J. Med. Genet. 32: 668-672, 1995. [PubMed: 7473667] [Full Text: http://jmg.bmj.com/cgi/pmidlookup?view=long&pmid=7473667%5D

Lurie, I. W., Wulfsberg, E. A. The McKusick-Kaufmann syndrome: phenotypic variation observed in familial cases as a clue for the evaluation of sporadic cases. Genet. Counsel. 5: 275-281, 1994. [PubMed: 7811428]

Narumi, Y., Kosho, T., Tsuruta, G., Shiohara, M., Shimazaki, E., Mori, T., Shimizu, A., Igawa, Y., Nishizawa, S., Takagi, K., Kawamura, R., Wakui, F., Fukushima, Y. Genital abnormalities in Pallister-Hall syndrome: report of two patients and review of the literature. Am. J. Med. Genet. 152A: 3143-3147, 2010. [PubMed: 21108399] [Full Text: https://dx.doi.org/10.1002/ajmg.a.33720%5D

Ondrey, F., Griffith, A., Van Waes, C., Rudy, S., Peters, K., McCullagh, L., Biesecker, L. G. Asymptomatic laryngeal malformations are common in patients with Pallister-Hall syndrome. Am. J. Med. Genet. 94: 64-67, 2000. [PubMed: 10982485] [Full Text: http://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0148-7299&date=2000&volume=94&issue=1&spage=64%5D

Pallister, P. D., Hecht, F., Herrman, J. Three additional cases of the congenital hypothalamic ‘hamartoblastoma’ (Pallister-Hall) syndrome. (Letter) Am. J. Med. Genet. 33: 500-501, 1989. [PubMed: 2596511] [Full Text: http://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0148-7299&date=1989&volume=33&issue=4&spage=500%5D

Penman Splitt, M., Wright, C., Perry, R., Burn, J. Autosomal dominant transmission of Pallister-Hall syndrome. Clin. Dysmorph. 3: 301-308, 1994. [PubMed: 7894735]

Sama, A., Mason, J. D. T., Gibbin, K. P., Young, I. D., Hewitt, M. The Pallister-Hall syndrome. (Letter) J. Med. Genet. 31: 740 only, 1994. [PubMed: 7815447] [Full Text: http://jmg.bmj.com/cgi/pmidlookup?view=long&pmid=7815447%5D

Say, B., Gerald, P. S. A new polydactyly–imperforate-anus–vertebral-anomalies syndrome? (Letter) Lancet 292: 688 only, 1968. Note: Originally Volume II. [PubMed: 4175523] [Full Text: https://linkinghub.elsevier.com/retrieve/pii/S0140-6736(68)92549-X%5D

Sills, I. N., Rapaport, R., Desposito, F., Lieber, C. Familial Pallister-Hall syndrome: three affected offspring. (Letter) Am. J. Med. Genet. 52: 251 only, 1994. [PubMed: 7802025] [Full Text: http://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0148-7299&date=1994&volume=52&issue=2&spage=251%5D

Sills, I. N., Rapaport, R., Robinson, L. P., Lieber, C., Shih, L. Y., Horlick, M. N. B., Schwartz, M., Desposito, F. Familial Pallister-Hall syndrome: case report and hormonal evaluation. Am. J. Med. Genet. 47: 321-325, 1993. [PubMed: 8135274] [Full Text: http://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0148-7299&date=1993&volume=47&issue=3&spage=321%5D

Stoll, C., de Saint Martin, A., Donato, L., Alembik, Y., Sauvage, P., Messer, J. Pallister-Hall syndrome with stenosis of the cricoid cartilage and microphallus without hypopituitarism. Genet. Counsel. 12: 231-235, 2001. Note: Erratum: Genet. Counsel. 13: 69 only, 2002. [PubMed: 11693785]

Thomas, H. M., Todd, P. J., Heaf, D., Fryer, A. E. Recurrence of Pallister-Hall syndrome in two sibs. J. Med. Genet. 31: 145-147, 1994. [PubMed: 8182722] [Full Text: http://jmg.bmj.com/cgi/pmidlookup?view=long&pmid=8182722%5D

Topf, K. F., Kletter, G. B., Kelch, R. P., Brunberg, J. A., Biesecker, L. G. Autosomal dominant transmission of the Pallister-Hall syndrome. J. Pediat. 123: 943-946, 1993. [PubMed: 8229528]

Unsinn, K. M., Neu, N., Krejci, A., Posch, A., Menardi, G., Gassner, I. Pallister-Hall syndrome and McKusick-Kaufmann (sic) syndrome: one entity? J. Med. Genet. 32: 125-128, 1995. [PubMed: 7760322] [Full Text: http://jmg.bmj.com/cgi/pmidlookup?view=long&pmid=7760322%5D

Verloes, A. Numerical syndromology: a mathematical approach to the nosology of complex phenotypes. Am. J. Med. Genet. 55: 433-443, 1995. [PubMed: 7762583] [Full Text: http://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0148-7299&date=1995&volume=55&issue=4&spage=433%5D

Verloes, A., David, A., Ngo, L., Bottani, A. Stringent delineation of Pallister-Hall syndrome in two long surviving patients: importance of radiological anomalies of the hands. J. Med. Genet. 32: 605-611, 1995. [PubMed: 7473651] [Full Text: http://jmg.bmj.com/cgi/pmidlookup?view=long&pmid=7473651%5D

Verloes, A., Gillerot, Y., Langhendries, J.-P., Fryns, J.-P., Koulischer, L. Variability versus heterogeneity in syndromal hypothalamic hamartoblastoma and related disorders: review and delineation of the cerebro-acro-visceral early lethality (CAVE) multiplex syndrome. Am. J. Med. Genet. 43: 669-677, 1992. [PubMed: 1621756] [Full Text: http://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0148-7299&date=1992&volume=43&issue=4&spage=669%5D

Verloes, A., Narcy, F., Fallet-Bianco, C. Syndromal hypothalamic hamartoblastoma with holoprosencephaly sequence, microphthalmia, pulmonary malformations, radial hypoplasia and mullerian regression: further delineation of a new syndrome? Clin. Dysmorph. 4: 33-37, 1995. [PubMed: 7735503]

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OMIM Entry – # 146510 – PALLISTER-HALL SYNDROME; PHS

Hypopituitarism in Children | Children’s Hospital of Philadelphia

Hypopituitarism is a condition in which the pituitary gland in the brain is not working properly. Normally, the pituitary gland produces hormones some of which affect growth, blood pressure, blood sugar and other body processes. Effects of hypopituitarism may be gradual, or sudden and dramatic.

Hypopituitarism, in children, is often caused by a benign (noncancerous) pituitary tumor, an injury, an autoimmune process, or an infection. Often, no exact cause can be determined.

Symptoms vary depending on what hormones are insufficiently producedfrom the pituitary gland. The symptoms of hypopituitarism may resemble other conditions or medical problems. Always consult yourdoctor for a diagnosis. Common symptoms include:

Small penis in males

Very low blood sugar (hypoglycemia)

Slowed growth and short stature

Slowed sexual development

Prolonged jaundice at birth

Poor appetite

Weight loss or weight gain

Sensitivity to cold

Facial puffiness

The symptoms of several underactive glands may help your child’sdoctor diagnose hypopituitarism. In addition to a complete medical history and physical exam, diagnostic procedures for hypopituitarism may include:

Computed tomography scan (also called a CT or CAT scan).A diagnostic imaging procedure that uses a combination of X-rays and computer technology to producehorizontal, or axial,images (often called slices)of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

Magnetic resonance imaging (MRI).A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

Blood tests. Blood tests are used to measure hormone levels.

Bone X-rays of the hand. X-rays of the left hand and wrist willdetermine bone age, which is often delayed compared with chronologic age inchildren with hypopituitarism..

Specific treatment for hypopituitarism will be determined by your child’sdoctor based on:

Your child’s age, overall health, and medical history

Extent of the disease

Your child’s tolerance for specific medications, procedures, or therapies

Expectations for the course of the disease

Your opinion or preference

Treatment of hypopituitarism depends on its cause. The goal of treatment is to restore the pituitary gland to normal function, producing normal levels of hormones. Treatment may include specific hormone replacement therapy, surgical tumor removal, and/or radiation therapy.

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Hypopituitarism in Children | Children’s Hospital of Philadelphia

What is hypopituitarism? | The Pituitary Foundation

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The pituitary gland produces a number of hormones or chemicals which are released into the blood to control other glands in the body. If the pituitary is not producing one or more of these hormones, or not producing enough, then this condition is known as hypopituitarism.

The term Multiple Pituitary Hormone Deficiency (MPHD) is sometimes used to describe the condition when the pituitary is not producing two or more of these hormones. If all the hormones produced by the pituitary are affected this condition is known as panhypopituitarism.

Hypopituitarism is most often caused by a benign (i.e. not cancerous) tumour of the pituitary gland, or of the brain in the region of the hypothalamus. Pituitary underactivity may be caused by the direct pressure of the tumour mass on the normal pituitary or by the effects of surgery or radiotherapy used to treat the tumour. Less frequently, hypopituitarism can be caused by infections (such as meningitis) in or around the brain or by severe blood loss, by head injury, or by various rare diseases such as sarcoidosis (an illness which resembles tuberculosis).

More information about conditions which result in hypopituitarism can be found in the Rarer Disorders section.

Each of the symptoms described above occur in response to the loss of one or more of the hormones produced by the pituitary. Decrease in the production of only one hormone would not lead to all the symptoms described above.

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What is hypopituitarism? | The Pituitary Foundation

Hypopituitarism – Diagnosis and treatment – Mayo Clinic

Diagnosis

If your doctor suspects a pituitary disorder, he or she will likely order several tests to check levels of various hormones in your body. Your doctor may also want to check for hypopituitarism if you’ve had a recent head injury or radiation treatment that might have put you at risk of damage to your pituitary gland.

Tests your doctor may order include:

Successful treatment of the underlying condition causing hypopituitarism may lead to a complete or partial recovery of your body’s normal production of pituitary hormones. Treatment with the appropriate hormones is often the first step. These drugs are considered as “replacement,” rather than treatment, because the dosages are set to match the amounts that your body would normally manufacture if it didn’t have a pituitary problem. Treatment may be lifelong.

Treatment for pituitary tumors may involve surgery to remove the growth. In some instances, doctors also recommend radiation treatment.

Hormone replacement medications may include:

If you’ve become infertile, LH and FSH (gonadotropins) can be administered by injection to stimulate ovulation in women and sperm production in men.

A doctor who specializes in endocrine disorders (endocrinologist) may monitor the levels of these hormones in your blood to ensure you’re getting adequate but not excessive amounts.

Your doctor will advise you to adjust your dosage of corticosteroids if you become seriously ill or experience major physical stress. During these times, your body would ordinarily produce extra cortisol hormone. The same kind of fine-tuning of dosage may be necessary when you have the flu, experience diarrhea or vomiting, or have surgery or dental procedures. Adjustments in dosage may also be necessary during pregnancy or with marked changes in weight. You may need periodic CT or MRI scans as well to monitor a pituitary tumor or other diseases causing the hypopituitarism.

Wear a medical alert bracelet or pendant, and carry a special card, notifying others in emergency situations, for example that you’re taking corticosteroids and other medications.

You’re likely to start by seeing your family doctor or a general practitioner. However, in some cases, when you call to set up an appointment, you may be referred to a specialist called an endocrinologist.

Here’s some information to help you prepare for your appointment.

Create a list of questions before your appointment so that you can make the most of your time with your doctor. For hypopituitarism, some basic questions to ask your doctor include:

Don’t hesitate to ask any questions you have during your appointment.

Your doctor is likely to ask you some questions, such as:

Aug. 22, 2017

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Hypopituitarism – Diagnosis and treatment – Mayo Clinic

Hypopituitarism in Kids: Definition, Symptoms, Treatment

What is Hypopituitarism in Children?

The pituitary gland sends signals to other glands to produce hormones (for example, it makes thyroid stimulating hormone (TSH – which regulates production of thyroid hormone by the thyroid gland). The hormones released by the pituitary and other glands have a significant impact on important bodily functions, such as growth, reproduction, blood pressure, and metabolism (the physical and chemical processes of the body). When levels of one or more of these hormones are not properly balanced, the body’s normal functions can be affected.

The pituitary gland produces several hormones.

In hypopituitarism, the level of one or more of these pituitary hormones is insufficient. The lack of hormone results in a loss of function of the gland or organ that it controls.

The most common pituitary hormone deficiency is growth hormone deficiency. In the United States, growth hormone deficiency occurs rarely with a frequency of less than 1 in 3,480 children.

Hypopituitarism in Children Causes

Hypopituitarism may be congenital (a condition present at birth) and caused by:

Hypopituitarism can also be acquired (a condition that develops later in life) and may be caused by:

Hypopituitarism in Children Symptoms

Symptoms vary depending on the child’s age, underlying cause, and the involved hormone. Signs and symptoms may develop gradually and may not be specific.

Signs and symptoms that may be present in newborn babies include:

When to Seek Medical Care fo Hypopituitarism

Call the doctor or health care practitioner if the child develops symptoms.

Exams and Tests for Hypopituitarism

Blood tests may be performed to determine which hormone is low or absent.

The doctor may obtain an MRI of the brain to assess the structure of the pituitary or to detect a tumor.

Hypopituitarism Treatment

Treatment primarily involves hormone replacement therapy.

Medications

Drugs used to treat hypopituitarism replace the deficient hormone.

Hypopituitarism Surgery

Surgery may be performed if a tumor is present within or near the pituitary gland, depending on the type and location of the tumor, and depending on the symptoms being experienced.

Hypopituitarism Follow-up

The doctor or health care practitioner may schedule routine checkups every three months to monitor growth and development.

Frequent checkups for children on growth hormone replacement therapy may be scheduled to monitor progress and side effects.

A doctor who specializes in studying hormones (a pediatric endocrinologist) should supervise the treatment of children with hypopituitarism.

Outlook for Hypopituitarism

With appropriate treatment, the prognosis is very good.

John A. Seibel, MD; Board Certified Internal Medicine with a subspecialty in Endocrinology & Metabolism

REFERENCE:

“Causes and clinical manifestations of central adrenal insufficiency in children”UpToDate.com

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Hypopituitarism in Kids: Definition, Symptoms, Treatment

Hypopituitarism | Hormone Health Network

More about Rare Diseases

Hypopituitarism (also called pituitary insufficiency) is a rare condition in which your pituitary gland doesn’t make enough of certain hormones. Your body can’t work properly when important glands, such as your thyroid gland and adrenal gland, don’t get the hormones they need from your pituitary gland. Hypopituitarism can develop very slowly, over several months or even over several years.

Hypopituitarism can be caused by:

Sometimes, the cause is unknown.

Symptoms can include one or more of the following:

Your doctor will check your hormone levels with blood tests. You may have other tests, such as an MRI of your pituitary gland, to help find the cause of your hypopituitarism.

Treatment usually includes taking the hormones you’re missing, sometimes for life. Your doctor also will teach you how to take extra cortisone (a hormone) when you are sick or under stress. If a tumor is causing your hypopituitarism, you might need surgery to remove it and/or possibly radiation treatment. If needed, you can take medicine for infertility.

You will need to get regular check-ups. It’s wise to wear medical identification, such as a bracelet or pendant, which provides information about your condition in case of an emergency.

You can expect a normal life span, as long as you regularly take the medications recommended by your doctor.

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Hypopituitarism | Hormone Health Network

Hypopituitarism – Symptoms, Causes, Diagnosis and Treatment – Prime Health Channel

[Total: 0 Average: 0/5] What is Hypopituitarism ?

Hypopituitarism refers to a rare clinical syndrome that is characterized by the low secretion of one or more hormones secreted by the pituitary gland. It is a condition primarily affecting the anterior lobe of the pituitary gland. The hormones that are produced by the pituitary glands and may be affected by hypopituitarism are Adrenocorticotrophic Hormone (ACTH), Antidiuretic Hormone (ADH), Follicle-Stimulating Hormone (FSH), Thyroid-Stimulating Hormone (TSH), Luteinizing Hormone (LH), Growth Hormone (GH) and Prolactin. When any one of these hormones is affected, one is considered to suffer from Partial Hypopituitarism and the case involving several hormones at a time is known as Panhypopituitarism. The German physician, Dr.Morris Simmonds can be credited to have detected and described the first such condition as early as 1914. Both children and adults may suffer from hypopituitarism which may be caused by a number of reasons affecting the pituitary glands. An underactive pituitary gland affects the normal body functions. One who is affected with hypopituitarism since birth or inherits the same, is said to suffer from congenital or postpartum hypopituitarism. However, like hypoparathyroidism, hypopituitarism is a disease that is most likely to last for life, so its treatment also lasts long.

The symptoms of hypopituitarism basically depend on the deficiency of a particular hormone secreted by the pituitary glands and its severity as well as the underlying cause responsible for it as. The signs and symptoms of hypopituitarism are usually subtle in nature but may also appear very suddenly.

In cases such as insufficient gonadotropins production that is actually secreted by the follicle-stimulating hormone and the luteinizing hormone, one may experience sexual problems such as hot flashes, infertility, impotence, loss of pubic hair, decreased sperm production, drying of the vagina, shriveling of the testes, amenorrhea or the absence of menstrual cycle in women and altogether a decreased sex drive. It may also cause osteoporosis in adults. The deficiency of such a hormone may be responsible for delaying puberty in children.

Insufficient production of the growth hormone caused by hypopituitarism in adults usually has no specific symptoms. But growth hormone deficiency may cause hypopituitarism dwarfism in children. This kind of specific hormone deficiency is more associated with people already suffering from tumor in the pituitary glands. One may suffer from the enlargement of the limbs or acromegaly, headaches, autoimmune inflammation of the pituitary glands or lymphocytic hypophysitis, and pituitary apoplexy or stroke.

The deficiency or the poor secretion of the TSH may be signaled by the gain or loss of weight, puffiness or the drying of the skin, sensitivity towards cold, constipation and even cretinism. The poor functioning of the pituitary glands to produce the ACTH or the prolactin results in low blood pressure, fatigue, stress, low blood sugar, anemia and the lack of production of breast milk in women after the birth of a child. On a more general sense, people with hypopituitarism may suffer from skin, nail and hair problems.

The causes of hypopituitarism are quite a few in number and also quite distinct by nature. The most common cause of hypopituitarism is the development of tumor in any of the pituitary glands. Such a condition is also known as pituitary adenomas in which case the normal tissues in the gland are compressed and it may also cause brain tumors, namely, craniopharyngiomas, glioma, chordoma, metastasis, ependymoma, and meningioma that are actually derivatives from pituitary gland problems. Cancer may also aggravate hypopituitarism.

Other common causes of hypopituitarism include hypophysis trauma, brain injury, ill effects of neurosurgical operations and ionizing radiation therapies to cure brain tumors and transsphenoidal adenomectomy.

Infections of the brain or the pituitary glands such as meningitis, brain abscess, syphilis, and encephalitis may also be responsible for causing hypopituitarism. Inflammatory diseases like amyloidosis and sarcoidosis are other causes of hypopituitarism. Diseases associated with infiltration by abnormal cells, histiocytosis and neurosarcoidosis may also be held responsible for hypopituitarism. Autoimmune diseases such as lymphocytic hypophysitis, empty sella syndrome that causes the disappearance of the pituitary tissues, and hemochromatosis or excessive iron content in the body may also be attributed to the occurrence of hypopituitarism.

Vascular hypopituitarism is a disease that affects pregnant women when their pituitary gland is harmed due to hemorrhage or infarction, or excessive bleeding following a delivery, a condition known as Sheehanss Syndrome. Pituitary apoplexy and strokes may also be held responsible for the same. On the other hand, congenital hypopituitarism is a disorder that affects a child since his/her birth. It may arise as a result of genetic complications or complications related to the birth. Certain specific gene mutations may cause the poor development of the pituitary glands to such an extent that they even be on the verge of dysfunction. The condition related to the insufficient development of the glands is called hypoplasia. Congenital hypopituitarism may also be caused by the Kallmann Syndrome which causes a deficiency of the sex hormones.

Certain other syndromes such as Prader-Willi and Biedl, chronic metabolic and autoimmune syndromes such as diabetes insipidus may also be responsible for causing hypopituitarism. Any other kind of damage to the nerves or the vessels by either internal or external factors may also cause the deficiency of the pituitary hormones.

Some of the symptoms of hypopituitarism are so obvious and serious that may facilitate the easy diagnosis of the disorder. But for discerning the exact reason behind hypopituitarism, one must go through the proper clinical tests, which shall help in the proper diagnosis of the ailment.

Blood tests are the most common form of clinical test that is beneficial in the proper diagnosis of just not hypopituitarism but for most of the diseases and disorders. The blood tests are usually of two types, namely, basal level tests and dynamic tests. Basal level tests have a specific timing for the collection of blood samples, mostly early morning when one is not stimulated before being injected. One the other hand, dynamic tests requires one to get injected by a stimulant before conducting the actual blood test. Basal level tests are conducted in the case of the measurement of the FSH, TSH and prolactin. Whereas, low levels of growth hormone and ACTH can be detected by the dynamic blood test.

Another way to detect the cause of hypopituitarism is to undergo an x-ray of the neck, hand or the wrist. This is a way most common in cases related to hypopituitarism in children. However, if this method does not prove to be helpful, one may take recourse to the other imaging tests such as CT scan or an MRI.

CT scan or Computed Tomography and MRI are non-invasive diagnosis procedures that helps to detect any kind of abnormality just not associated with the pituitary glands but the body as a whole.

In addition to these, vision tests are conducted specially on children to conform if hypopituitarism tumor has caused any kind of impairment to the eyes. Moreover, in case of congenital hypopituitarism, one may be asked to undergo a genetic test in order to discern the exact cause of hypopituitarism. Urine specific gravity test is used for patients with hypopituitarism and diabetes. All of these diagnostic procedures facilitate the treatment of hypopituitarism.

The treatment for hypopituitarism depends on the underlying cause of the disease that has been detected through the various ways of diagnosis. Some of the treatment methods that are adopted include medicines, drugs, hormone replacement therapy, and radiation therapy. Surgeries and radiation therapies are usually performed in case of pituitary tumors.

The hormone replacement medications perform the similar functions that insulin is supposed to perform in case of diabetes. Such medications help the pituitary glands to artificially produce the hormones that it is deficient in. Some of the most commonly prescribed medications are corticosteroids such as prednisone and hydrocortisone, levothyroxine like synthroid and levoxyl, desmopression, sex hormones, namely, testosterone, progesterone and estrogen, and artificial growth hormones like the somatropin. Corticosteroids help in making up for ACTH deficiency, Levothyroxines help in replacing deficient TSH. Desmopression (DDAVP) or Vasopressin helps in the case of ADH deficiency and also to treat diabetes insipidus. The sex hormones are administered either through the skin to compensate for the deficiency of sex hormones in case of hypopituitarism. In fact, in case of severe hypopituitarism due to FSH and LH deficiency, one may have to be administered gonadotropins to stimulate the production of the sex hormones. The artificially produced growth hormones help in raising the height of children who had to suffer from a stunted growth due to hypopituitarism.

A surgery is usually conducted if one detects a tumor in the vicinity of the pituitary glands. Radiation therapies also serve the purpose of damaging the tumor through powerful radiations.

However, hypopituitarism is a disorder from which one cant escape till ones death. So, one need to go through routine tests in order to monitor the effects of the disorder and take precautions to thwart away the complications involved with hypopituitarism. So, undertaking the treatment for hypopituitarism under the supervision of an endicronologist is the best way to keep it on tabs.

References :

Wikipedia

http://www.emedicinehealth.com

http://www.mayoclinic.com

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Hypopituitarism – Symptoms, Causes, Diagnosis and Treatment – Prime Health Channel

Hypopituitary: Hypopituitarism Causes, Symptoms & Treatment

What is Hypopituitaryism?

What Causes Hypopituitary?

A loss of function of the pituitary gland or hypothalamus results in low or absent hormones. Tumors can cause damage to the pituitary gland or hypothalamus and can therefore result in a loss of function. Damage to the pituitary gland can also be caused by radiation, surgery, infections (eg, meningitis), or various other conditions. In some cases, the cause is unknown.

What Are the Symptoms of Hypopituitary?

Some persons may have no symptoms or a gradual onset of symptoms. In other persons, the symptoms may be sudden and dramatic. The symptoms depend on the cause, rapidity of onset, and the hormone that is involved.

When to See a Doctor for Hypopituitary

Call the doctor or health care practitioner if any symptoms develop.

What Exams and Tests Diagnose Hypopituitary?

The doctor or health care practitioner may perform blood tests to determine which hormone level is low and to rule out other causes. The following tests may be performed:

An MRI or CT scan of the pituitary gland may be obtained to determine if a tumor is present.

In children, X-rays of the hands may be taken to determine if bones are growing normally.

What Is the Treatment for Hypopituitary?

Medical treatment consists of hormone replacement therapy and treatment of the underlying cause.

What Are the Medications Used to Treat Hypopituitary?

Drugs used to treat hypopituitarism replace the deficient hormone.

Is Surgery a Treatment Option for Hypopituitary?

Surgery may be performed depending on the type, size, and location of the tumor.

What Is the Follow-up for Hypopituitary?

Checkups with the doctor or health care practitioner are important. The doctor may need to adjust the dose of hormone replacement therapy.

What Is the Outlook for Hypopituitary?

If hormone replacement therapy is adequate, the prognosis is good. Complications are often related to the underlying disease.

Reviewed on 1/3/2018

Medically reviewed by John A. Daller, MD; American Board of Surgery with subspecialty certification in surgical critical care

REFERENCE:

“Clinical manifestations of hypopituitarism”

UpToDate.com

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Hypopituitary: Hypopituitarism Causes, Symptoms & Treatment

Generalized Hypopituitarism – Endocrine and Metabolic …

Generalized hypopituitarism refers to endocrine deficiency syndromes due to partial or complete loss of anterior lobe pituitary function. Various clinical features occur depending on the specific hormones that are deficient. Diagnosis involves imaging tests and measurement of pituitary hormone levels basally and after various provocative stimuli. Treatment depends on cause but generally includes removal of any tumor and administration of replacement hormones.

Hypopituitarism is divided into

Primary: Caused by disorders that affect the pituitary gland

Secondary: Caused by disorders of the hypothalamus

The different causes of primary and secondary hypopituitarism are listed in the table below (see Table: Causes of Hypopituitarism).

Causes primarily affecting the pituitary gland (primary hypopituitarism)

Infarction or ischemic necrosis

Hemorrhagic infarction (pituitary apoplexy)

Vascular thrombosis or aneurysm, especially of the internal carotid artery

Meningitis (tubercular, other bacterial, fungal, malarial)

Idiopathic isolated or multiple pituitary hormone deficiencies

Drugs (eg hypophysitis due to antimelanoma monoclonal antibodies)

Causes primarily affecting the hypothalamus (secondary hypopituitarism)

Neurohormone deficiencies of the hypothalamus

Surgical transection of the pituitary stalk

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Generalized Hypopituitarism – Endocrine and Metabolic …

Hypopituitarism – Symptoms and causes – Mayo Clinic

Overview

Hypopituitarism is a rare disorder in which your pituitary gland either fails to produce one or more of its hormones or doesn’t produce enough of them.

The pituitary gland is a small bean-shaped gland situated at the base of your brain, behind your nose and between your ears. Despite its size, this gland secretes hormones that influence nearly every part of your body.

In hypopituitarism, you have a short supply of one or more of these pituitary hormones. This deficiency can affect any number of your body’s routine functions, such as growth, blood pressure and reproduction.

You’ll likely need medications for the rest of your life to treat hypopituitarism, but your symptoms can be controlled.

Hypopituitarism is often progressive. Although the signs and symptoms can occur suddenly, they more often develop gradually. They are sometimes subtle and may be overlooked for months or even years.

Signs and symptoms of hypopituitarism vary, depending on which pituitary hormones are deficient and how severe the deficiency is. They may include:

See your doctor if you develop signs and symptoms associated with hypopituitarism.

Contact your doctor immediately if certain signs or symptoms of hypopituitarism develop suddenly or are associated with a severe headache, visual disturbances, confusion or a drop in blood pressure. Such signs and symptoms could represent sudden bleeding into the pituitary gland (pituitary apoplexy), which requires prompt medical attention.

Hypopituitarism may be the result of inherited disorders, but more often it’s acquired. Hypopituitarism frequently is triggered by a tumor of the pituitary gland. As a pituitary tumor increases in size, it can compress and damage pituitary tissue, interfering with hormone production. A tumor can also compress the optic nerves, causing visual disturbances.

The cause of hypopituitarism can also be other diseases and events that damage the pituitary, such as:

Diseases of the hypothalamus, a portion of the brain situated just above the pituitary, also can cause hypopituitarism. The hypothalamus produces hormones of its own that directly affect the activity of the pituitary.

In some cases, the cause of hypopituitarism is unknown.

Aug. 22, 2017

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Hypopituitarism – Symptoms and causes – Mayo Clinic

Hypopituitarism: Causes, Symptoms, and Treatment

Whatis an underactive pituitary gland?

Your pituitary gland is located on the underside of your brain. It releases eight hormones. Each of these hormones plays a role in how your body function. These functions range from stimulating bone growth to prompting your thyroid gland to release hormones that control your metabolism.

Hormones produced by the pituitary gland include:

Hypopituitarism occurs when your pituitary gland does not release enough of one or more of these hormones.

What causes an underactive pituitary gland?

Trauma may cause your pituitary gland to stop producing enough of one or more of its hormones. For example, if you had brain surgery, a brain infection, or a head injury, may affect your pituitary gland.

Certain tumors can also affect the function of this gland. These include:

Some other possible causes of hypopituitarism include:

There may also be other causes of hypopituitarism. And in some cases hypopituitarism, the cause may be unknown.

What are the symptoms of an underactive pituitary gland?

The symptoms of hypopituitarism depend on which hormones your pituitary gland is not producing enough of. For example, if the pituitary gland does not produce enough growth hormone in a child, they may have a permanently short stature. If it doesnt produce enough follicle-stimulating hormone or luteinizing hormone, it might cause problems with sexual function, menstruation, and fertility.

How is an underactive pituitary gland diagnosed?

If your doctor thinks you may have hypopituitarism, they will use a blood test to check your levels of the hormones the pituitary gland produces. They may also check for hormones your pituitary gland stimulates other glands to release.

For example, your doctor may check your T4 levels. Your pituitary gland doesnt produce this hormone, but it releases TSH, which stimulates your thyroid gland to release T4. Having low levels of T4 indicates you may have a problem with your pituitary gland.

Your doctor may prescribe specific medications before doing blood tests. These medications will stimulate your bodys production of specific hormones. Taking them before the test can help your doctor better understand your pituitary gland function.

Once your doctor determines which hormone levels are low, they must check the parts of your body (target organs) those hormones affect. Sometimes, the problem isnt with your pituitary gland, but rather with the target organs.

Your doctor may also perform imaging tests, such as a CT scan or MRI scan on your brain. These tests can help your doctor figure out if a tumor on your pituitary gland is affecting its function.

How is an underactive pituitary gland treated?

This condition is best managed by an endocrinologist. There is no single course of treatment because this condition may affect a number of hormones. In general, the goal of treatment is to bring all your hormone levels back to normal.

This may involve taking medications to replace the hormones your pituitary gland is not producing properly. In this case, your doctor will need to check your hormone levels regularly. This allows your doctor to adjust the doses of medications youre taking to make sure youre getting the correct dose.

If a tumor is causing your pituitary problems, surgery to remove the tumor may restore your hormone production to normal. In some cases, getting rid of a tumor will also involve radiation therapy.

Read more here:
Hypopituitarism: Causes, Symptoms, and Treatment

LABOKLIN (UK)| Genetic Diseases | Dogs| Dwarfism …

Dwarfism (Pituitary Dwarfism / Hypopituitarism)

Test number: 8142

DWARFISM

clear

100% clear

clear

carrier

50% clear + 50% carriers

clear

affected

100% carriers

carrier

clear

50% clear + 50% carriers

carrier

carrier

25% clear + 25% affected + 50% carriers

carrier

affected

50% carriers + 50% affected

affected

clear

100% carriers

affected

carrier

50% carriers + 50% affected

affected

affected

100% affected

Clear

Genotype: N / N [ Homozygous normal ]

The dog is noncarrier of the mutant gene.

Carrier

Genotype: N / DWARFISM [ Heterozygous ]

The dog carries one copy of the mutant gene and one copy of the normal gene.

Carriers should only be bred to clear dogs.

Avoid breeding carrier to carrier because 25% of their offspring is expected to be affected (see table above)

Affected

Genotype: DWARFISM / DWARFISM [ Homozygous mutant ]

The dog carries two copies of the mutant gene and therefore it will pass the mutant gene to its entire offspring.

By DNA testing, the responsible mutation can be shown directly. This method provides a test with a very high accuracy. It offers the possibility to distinguish not only between affected and clear dogs, but also to identify clinically healthy carriers. This is an essential information for controlling the condition in the breed, as carriers are able to spread the disease in the population.

test will be performed at a partner laboratory

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LABOKLIN (UK)| Genetic Diseases | Dogs| Dwarfism …

Prevalence of Hypopituitarism in Veterans 42% A NEW …

Why are they not doing something with this information? At least 2 million of our Veterans are needlessly suffering when treatment is available!!

Research showsabout 24% of US Veterans who return home from war suffer from PTSD. (With21.8 million veterans of the U.S. armed forces as of 2014, that means about 5.2 million Veterans suffer from PTSD.)Research shows42% of those Veterans who come home with PTSD actually have Hypopituitarism, and when treated, their PTSD symptoms (including depression, and other mental and physical health disorders) actually go away!

That means atleast 2 million Veterans in the United States are needlessly suffering from undiagnosed hypopituitarism. And of Veterans diagnosed with a Traumatic Brain Injury from war, the percent who may have hypopituitarism could be as high as 80%.

What is hypopitutarism? Its when the brain is not able to send signals to cells throughout the body to control all things homeostasis. Everything metabolic. Everything that makes you human. Blood, heart, bone, and muscle function, mental health, sleep cycle, reproductive function, ability to heal and fight infection, and much more. Without these brain signals, you are always unwell, and sentenced to a life of illness and certainlyan early death.

When you google Veterans and PTSD, about 25millionresults come back. When you google Veterans and Hypopituitarism, only 226,000 results come back. Yet nearly half of Veterans with PTSD actually have hypopituitarism. This awareness should spread like wildfire, 2 million veterans may get their lives back.

So why arent they getting a diagnosis? Because doctors dont know to lookfor the symptoms and they dont know the proper tests. The only doctors who are taught about Hypopit are endocrinologists, and they are taught that it is rare. They are misinformed by their textbooks and, admittedly, due to lack of research, there is gross missing information. Hypopit patients find medical professionals actually know very little about diagnosis, testing and treatment. Often times, Hypopit patients are put on anti-anxiety pills and antidepressants, instead of the treatment they need. A bandaid doesnt fix a bullet hole, it may cover it up for a little while, but the problem still exists. We need the textbooks to teach doctors that Hypopit is not rare and we need to teach them that anyone who has symptoms and has experienced a traumatic event should be properly tested.

2010 A recommendation was made by AMSUS (the Society of the Federal Health Professional) for hormonal testing of veterans who sustained and sort of traumatic brain injury.

Military Medicine Recent civilian data obtained in those sustaining head injuries, has found a high prevalence of pituitary dysfunction. Currently, there is no data available in the military population. We reviewed the literature for traumatic brain injury (TBI)-related hypopituitarism and found that the prevalence of anterior hypopituitarism may be as high as 3080% after 2436 months. Since many of the symptoms of hypopituitarism are similar to those of TBI, it is important to make clinicians caring for combat veterans aware of its occurrence. Herein, we provide an overview of the literature and recommendations for hormonal testing when TBI-related hypopituitarism is suspected.Read the full article here:

http://publications.amsus.org/doi/abs/10.7205/MILMED-D-09-00189

2013- Science Daily reported, Up to 20 percent of veterans returning from Afghanistan and Iraq have experienced at least one blast concussion. New research suggests that nearly half these veterans may have a problem so under-recognized that even military physicians may fail to look for it. A new study conducted by Charles W. Wilkinson, Elizabeth A. Colasurdo, Kathleen F. Pagulayan, Jane. B. Shofer, and Elaine R. Peskind, all of the VA Puget Sound Health Care System and the University of Washington in Seattle, has found that about 42 percent of screened veterans with blast injuries have irregular hormone levels indicative of hypopituitarism.View the article here:

http://www.sciencedaily.com/releases/2013/04/130422102029.htm

2013 American Physiological Society (APS). Nearly half of U.S. veterans found with blast concussions might have hormone deficiencies. .

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Prevalence of Hypopituitarism in Veterans 42% A NEW …

Pituitary Disorders – labtestsonline.org

NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used. To access online sources, copy and paste the URL into your browser.

Sources Used in Current Review

American Brain Tumor Association. 2014. Craniopharyngioma. Available online at http://www.abta.org/brain-tumor-information/types-of-tumors/craniopharyngioma.html. Accessed April 2, 2017.

Cleveland Clinic Center for Continuing Education. 2012. Pituitary Disorders. Available online at http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/endocrinology/pituitary-disorders/. Accessed April 2, 2017.

Goldberg J., and Jewell, T. 2016. Prolactin Level Test. Healthline. Available online at http://www.healthline.com/health/prolactin#overview1. Accessed March 31, 2017.

Hormone Health Network. 2012. Cushing Syndrome. Available online at http://www.hormone.org/diseases-and-conditions/adrenal/cushing-syndrome. Accessed April 2, 2017.

Hormone Health Network. 2013. Diabetes Insipidus. Available online at http://www.hormone.org/diseases-and-conditions/pituitary/diabetes-insipidus. Accessed April 2, 2017.

Hormone Health Network. 2012. Acromegaly. Available online at http://www.hormone.org/diseases-and-conditions/pituitary/acromegaly. Accessed April 2, 2017.

National Organization for Rare Disorders. 2013. Empty Sella Syndrome. Available online at https://rarediseases.org/rare-diseases/empty-sella-syndrome/. Accessed April 2, 2017.

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(2003 February 1, Revised). Central Diabetes Insipidus. The Merck Manual of Medical Information Second Home Edition [On-line information]. Available online at http://www.merck.com/mmhe/sec13/ch162/ch162d.html.

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Pituitary Disorders – labtestsonline.org

Severe hyponatremia due to hypopituitarism with adrenal …

Objective: Adrenal insufficiency due to hypopituitarism can lead to severe hyponatremia with potentially fatal consequences. Prompt diagnosis and adequate hormonal replacement therapy are essential to block an otherwise unfavorable course and to re-establish a healthy life. Unfortunately, this condition is often misdiagnosed. Design: Case report. Setting: Intensive Care Unit of a teaching hospital. Patient: A 76-yr-old man with refractory hypotension, acute myocardial infarction, and left ventricular dysfunction, secondary to severe chronic pan-hypopituitarism, associated with severe hyponatremia. Methods and main results: The patient underwent mechanical ventilation and continuous venous-venous hemodiafiltration, for severe respiratory and renal insufficiency. A hormonal replacement therapy with T4, hydrocortisone, and nandrolone was started and the patient was discharged to a rehabilitation facility after 31 days of hospitalization. Conclusions: Hypopituitarism with secondary adrenal insufficiency is often misdiagnosed at an early stage and a high degree of suspicion is necessary for early diagnosis. Determination of plasma cortisol level in patients with hyponatremia not explained by other causes should always be obtained.

Key-wordsHyponatremiapan-hypopituitarismadrenal insufficiencymyocardial infarctionhypothyroidism

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Italian Society of Endocrinology (SIE)2007

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Severe hyponatremia due to hypopituitarism with adrenal …

Hypopituitarism | You and Your Hormones from the Society …

Alternative names for hypopituitarism

Hypopit; pituitary insufficiency; partial hypopituitarism; panhypopituitarism (pan referring to all pituitary hormones being affected); anterior hypopituitarism

Hypopituitarism is failure of the pituitary gland to produce one, some, or all of the hormones it normally produces. The pituitary gland has two parts, the anterior pituitary and the posterior pituitary, and hormone production can be affected in both parts.

Below are listed some of the causes of hypopituitarism:

The signs and symptoms of hypopituitarism depend on which of the pituitary gland hormones are involved, to what extent and for how long. It also depends on whether the hormone deficiencies began as a child or later in adult life. Symptoms can be slow at the start and vague.It is worth understanding the normal function and effects of these hormones in order to understand the signs and symptoms of hypopituitarism. (See the article on pituitary gland.) There may also be additional symptoms due to the underlying cause of the hypopituitarism, such as the effects of pressure from a tumour.

Symptoms can include:

Hypopituitarism is rare. At any given time, between 300 and 455 people in a million may have hypopituitarism. A number of endocrinologists believe that hypopituitarism is quite common after brain injuries. If this belief is confirmed, then hypopituitarism may be significantly more common than previously believed.

Most cases of hypopituitarism are not inherited.However, there are some very rare genetic abnormalities than can cause hypopituitarism.

Blood tests are required to check the level of the hormones, which are either produced by the pituitary gland itself, or by peripheral endocrine glands controlled by the pituitary gland. These blood tests may be one-off samples or the patient may require more detailed testing on a day-unit. These are called dynamic tests and they measure hormone levels before and after stimulation to see if the normal pituitary gland is working properly.They usually last between1 to 4 hours.

If it is suspected that there is a lack of anti-diuretic hormone, the doctor may organise a water deprivation test. The patient will be deprived of water for a period of eight hours under very close supervision with regular blood and urine tests.The test may be extended to a 24 hour period if needed, which means an overnight stay in hospital.

Other tests may also be organised to try and identify the underlying cause of the hypopituitarism. These could include blood tests, scans such as computerised tomography (CT) or magnetic resonance imaging (MRI) scans, and tests for vision.

Hypopituitarism is treated by replacing the deficient hormones. Treatment will be tailored to the individual depending on which hormones they are deficient in:

Since the treatment of hypopituitarism only involves replacing hormones that the body should be making but is unable to, there should be no side-effects if the appropriate amounts of hormones are replaced.Patients will be monitored to ensure they are receiving the correct amount of replacement hormones. Some side-effects can occur from hormone replacement if the amount replaced is higher than the individuals body requirements.If the patient has any concerns, they should discuss them with their doctor.

People with long-term hypopituitarism will need to take daily medication and will require regular checks with an endocrinologist at an outpatients clinic.

People with hypopituitarism may have an impaired quality of life.Hypopituitarism is associated with an increased risk of heart disease and strokes as a result of the physical changes that occur in body fat, cholesterol and circulation. Healthy living, a balanced diet and exercise to prevent becoming overweight are essential to reduce this risk.

People with hypopituitarism also have a higher risk of developing osteoporosis or brittle bones and, therefore, have a higher risk of developing fractures from minor injuries. A diet that is rich in calcium and vitamin d along with moderate amounts of weight-bearing exercise and training are helpful in decreasing this risk.

Appropriate pituitary hormone replacement therapy can reduce all these risks.

Last reviewed: Jan 2015

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Hypopituitarism | You and Your Hormones from the Society …

The Pituitary Society | Glossary of Terms Related to …

ACTH

Adrenocorticotropic hormone. This hormone is produced by the pituitary gland and flows through the blood to the adrenal glands to tell them to produce more cortisol.

A benign tumor or growth. A pituitary adenoma is not cancerous.

Glands situated just above each of the kidneys and which produce various essential hormones including cortisol and aldosterone.

Surgical removal of the adrenal glands.

Anti-diuretic hormone or vasopressin. This hormone is produced by the pituitary and causes the kidneys to conserve body fluids.

An agonist is a molecule that triggers the same effects and actions as a naturally occurring molecule or hormone. It stimulates or activates cellular responses just like the natural hormone. For example, a dopamine agonist causes the same effect on cells as dopamine itself by binding to the same receptor on the surface of cells. This causes the cell to respond in the same way as it would in the presence of the real hormone.

The pituitary hormone that controls water balance.

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A drug of a type called dopamine agonists, which can be used to reduce prolactin production in people with prolactinomas. Its brand name is Parlodel and it is produced by Novartis.

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A drug of a type called dopamine agonists, which can be used to reduce prolactin production for people with prolactinomas. Its brand name is Dostinex and it is produced by Pfizer.

One of the hormones produced by the adrenal glands. It is particularly important in times of stress and illness.

A problem that occurred during fetal development (in the womb) that may grow at any time in life; not a cancer or brain tumor; often causes loss of pituitary function and may cause diabetes insipidus.

Corticotropin-releasing hormone normally made by the hypothalamus to stimulate ACTH production. In synthetic form, used to test for pituitary-dependent Cushing’s disease.

Cushing’s syndrome when caused by a tumour of the pituitary gland.

Caused by overproduction of cortisol for any reason.

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5-dehydroepiandrosterone is an steroid naturally produced by adrenal glands and synthesized in the brain. It is a prohormone, considered to be a precursor for the sex steroids.

A form of diabetes that results from water imbalance and is characterized by in frequent urination and excessive thirst.

A neurotransmitter mad in the brain which regulates prolactin secretion. The medicines used to treat prolactinomas are effective because they are designed to increase the action of dopamine.

Dopamine agonists such as bromocriptine (brand name Parlodel) and cabergoline (brand name Dostinex) inhibit GH release from the tumor. They work by stimulating natural receptorsof the hormone dopamine on the surface of the tumor. This sends messages into the tumor cells to stop producing GH.

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Production of ACTH from a site other than the pituitary gland.

Relating to hormone.

The body-wide system of hormone-producing glands, and the hormones they make, which control many aspects of life, including growth and reproduction.

A doctor who specializes in treating hormone illnesses.

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A medication that controls salt and water balance.

In every million people, three cases of acromegaly are diagnosed each year.

Follicle-stimulating hormone. This is one of the two pituitary hormones (with LH) that is released from the testes in men and the ovaries in women.

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A condition where a milky discharge is produced from the breasts in a woman who is not pregnant or lactating. Galactorrhea can also occur in men, but is rare.

Gigantism is a serious disorder where a person has grown very large and tall due to excess secretion of growth hormone from the pituitary gland during childhood. Heights of people suffering from this disorder can reach eight feet . For more information on this condition please visit: http://www.medterms.com/script/main/art.asp?articlekey=4914

As the name suggests, growth hormone (GH) stimulates physical growth in children. It is a hormone that is produced by the pituitary gland and has widespread effects on the body. After you have stopped growing at 17 or 18, the skeleton changes and is no longer able to increase in height. However, growth hormone still plays important roles in adulthood, such as maintaining muscle tone and regulating metabolism, energy levels and psychological wellbeing.

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A chemical substance produced by the endocrine glands of the body, which works by sending messages through the bloodstream.

Hormone therapy is the term used for any pharmaceutical/drug therapy given to an individual to provide particular hormones that are missing or present at an abnormally low level. If the pituitary gland is not functioning, specific hormonal therapy will be prescribed to replace those hormones that the gland would normally produce.

The drug name of cortisol when it is made into a tablet or injection.

A medical condition in which a patient has elevated blood levels of prolactin, most often due to a pituitary tumor (a prolactinoma). Normal prolactin levels are less than 25 ng/ml in women and less than 17 ng/ml in men. In addition to a pituitary tumor, some medications, hypothyroidism, and kidney disease can lead to elevated serum levels of prolactin.

Hypopituitarism is a disorder in which the pituitary gland does not produce the normal amounts of some or all of its hormones. Hypopituitarism can affect several systems and cause growth failure in children, low thyroid hormone production (necessary for metabolism), low cortisol (steroid) production, and loss of reproductive function (loss of menstrual cycles in women, low testosterone in men and problems with fertility in both men and women). This is an uncommon condition and all missing hormones can be replaced.

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IGF-1 is a very important hormone involved in growth and development, and it is made by many tissues in the body. IGF stands for insulin-like growth factor but you will probably hear the hormone referred to as I-G-F-one.

Insulin is a hormone secreted by a group of islet cells within the pancreas, which is an organ located near the stomach. Most cells in the body have insulin receptors that bind to circulating insulin, which triggers the cell to absorb glucose (sugar). Without insulin, cells are starved because they cannot access the calories contained in the glucose.

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Luteinizing hormone. This hormone is produced by the pituitary and sends messages to the reproductive organs (called gonads) the ovaries in women and testes in men. In children, LH contributes to sexual development. In women, it works together with FSH to control ovulation and is thus essential for a normal menstrual cycle and for fertility. In men FSH stimulates the testes to produce sperm.

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A prolactinoma that is 10 mm or larger.

A prolactinoma that is smaller than 10 mm (or about 1/2 inch).

Magnetic resonance imaging – a type of scan that produces a clear image and which is used to determine the size and location of the tumour.

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Pituitary hormone that causes contraction of the uterus during labor.

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Pegvisomant is a growth hormone antagonist. It does not lower the level of GH released from the tumor but it stops the hormone from acting on its targets in various parts of the body. This then prevents the effects of too much GH, such as overproduction of IGF-I. To do this pegvisomant binds to the natural receptors for growth hormone and gets in the way of the hormone being able to bind and send messages into cells. Imagine forcing the wrong key into a lock; the correct key cannot then fit in, and the lock cannot be opened.

A drug that is used to reduce prolactin production in people with prolactinomas. Its brand name is Permax and it is produced by Eli Lilly.

The pituitary gland is an important gland and it is often referred to as the ‘master gland’, because it controls several of the other hormone-producing glands. It is usually about the size of a pea and is situated in a bony hollow beneath the base of the brain and just behind the bridge of your nose. The gland consists of two parts (often called lobes) each of which has different functions. The pituitary gland is also sometimes called the hypophysis.

Prolactin. This hormone is produced by the pituitary and is usually best known as the milk hormone, because its main purpose is to stimulate the breasts to produce milk after childbirth. However, men and women produce prolactin all the time. Its purpose in men is unclear.

A hormone produced by the pituitary gland that stimulates the production of breast milk during pregnancy and the postpartum period.

An abnormal growth, or tumor, on the pituitary gland. The tumor is almost always noncancerous (benign) and causes the pituitary to produce too much prolactin which leads to hyperprolactinemia.

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A dopamine agonist approved for use in Europe, Canada, and Australia. The drug is not approved by the FDA for treatment of hyperprolactinemia in the US.

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Finely targeted radiation therapy using MRI to pinpoint the tumour.

Radiation treatment, usually used after surgery, which prevents regrowth of the tumour. Radiotherapy has a long-acting effect and may cause reduction of some of the other pituitary hormones over time, thus requiring them to be replaced.

A receptor is a specialized protein on the surface or interior of a cell that interacts only with very specific molecules in the surrounding environment. Receptors enable molecules or drugs outside cells to communicate a signal to the interior, causing a response within that cell.

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These mimic a natural hormone, called somatostatin, and latch onto the hormones natural receptors on the surface of the tumor. When this lock and key connection is made specific signals are sent into the tumor cells to make them stop producing GH.

Stimulation testing is conducted when your health care provider suspects you are not producing the appropriate amount of a hormone. The test varies depending on which hormone is being evaluated, but the test typically involves a pretest phase during which you may be required to fast or eat a very specific diet, and then a blood sample is collected.

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The thyroid is a gland that lies over the windpipe and just below the larynx. It produces hormones which are essential to numerous body processes.

Thyroid-stimulating hormone. A hormone produced by the pituitary, which sends a message to the thyroid gland to increase or decrease its production of the hormone, thyroxine.

A method of operating on the pituitary gland by making an incision in front of the upper teeth and behind the upper lip, or alternatively inside the nose. This allows the surgeon access to the pituitary via the sphenoid sinus and minimizes trauma to the patient.

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2003 Pituitary Society. All Rights Reserved. E&OE.

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The Pituitary Society | Glossary of Terms Related to …

What Is Hypopituitarism (Dwarfism)? – Verywell

Hypopituitarism (dwarfism) is a rare disease that results from the low production of hormones in the pituitary gland. The pituitary gland is located deep within your brain and is an important aspect of the endocrine system.

In children, human growth hormone deficiencies can lead to impaired growth, also known as dwarfism. Early diagnosis and medical intervention can sometimes correct this deficiency, allowing the affected individual to reach a normal or near-normal height.

In addition to stunted growth, hypopituitarism can also cause deficiencies in thyroid or adrenal hormones.

The most common cause of hypopituitarism is a tumor located in or around the pituitary gland. Surgery or radiation therapy near the pituitary gland can also stimulate dwarfism. In some rare cases, illnesses like tuberculosis can cause inflammation that causes hypopituitarism as well.

Besides slowed growth, there are many other symptoms of hypopituitarism:

Diagnosing hypopituitarism can be difficult as it often goes unnoticed early on. During the first two years of life, a child with growth hormone deficiency may grow at a normal rate and may seem perfectly healthy.

As the child becomes older, however, parents may notice that their child does not seem to be growing properly. The child may be smaller when compared to other kids his age and may look younger than them or have different proportions.

A child who grows less than 2 inches per year, or who is only as tall as children two or more years younger, should be evaluated by a physician for growth hormone deficiency after other possible causes, such as hypothyroidism, have been ruled out.

Your child’s doctor will look at the patient history, perform a physical exam and may recommend an X-ray to look for the presence of a tumor. He may also perform blood tests to check pituitary, thyroid and adrenal glands.

Testing for growth hormone deficiency is done by stimulating the body to produce the hormone and then measuring how much hormone is actually released.

In most cases, people with hypopituitarism will undergo hormonal therapy throughout their entire lifetimes. Depending on the individual’s deficiency, different hormones may be administered.

In order for a more normal height to be achieved, children will need to have human growth hormone replacement therapy. Growth hormone deficiency is treated by injections of a growth hormone preparation such as Humatrope (somatropin). A child may receive daily or weekly injections. The child’s growth rate increases soon after the injections are started. The treatment continues over several years until the child’s maximum growth potential is achieved. Most children will reach an “acceptable” adult height.

The average adult height for someone with untreated severe growth hormone deficiency is 4 feet, 8 inches in men and 4 feet, 3 inches in women, while those who undergo early treatments will reach more average heights in the range of 5 feet and up.

Sources:

Human Growth Foundation. “Disorders of Growth.” 2009.

Levy, Richard. “Growth Hormone Deficiency in Children.” The Magic Foundation.2009.

Pituitary Network Association. “Hypopituitarism.” 2014.

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What Is Hypopituitarism (Dwarfism)? – Verywell

Hormone Replacement Therapy Market: Industry Players to Show High Growth Rate by 2024 – Monotone Critic

Global Hormone Replacement Therapy Market: Overview

The medical treatment where the patients receive hormones to substitute the naturally occurring hormones with the other hormones or to add naturally occurring hormones that are absent is known as hormone replacement therapy. In the females that are at the stage of menopause, hormone replacement therapy is used to restore female hormone levels, so that the body functions normally.

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Global Hormone Replacement Therapy Market: Segmentation

The global hormone replacement therapy is fragmented into therapy type, distribution channel, and application. On the basis of a therapy type, the global market is segregated into estrogen replacement therapy, thyroid hormone replacement, and growth hormone replacement. The thyroid hormone replacement segment is further sub-segmented into tablets, injections, and capsules. The growth hormone replacement segment is sub-categorized into somatostatin analogs and dopamine agonist. On the basis of the distribution channel, the market is categorized into e-commerce, retail pharmacies and drugstores, hospital pharmacies, compounding pharmacies, and others. On the basis of application, the market is divided into hypothyroidism, menopause, cancer, hypopituitarism, and others.

Global Hormone Replacement Therapy Market: Growth Factors

The key factors that are driving the hormone replacement therapy market are enlarged demand for the regenerative medicines which include reproductive-cycle boosting and anti-aging. The market is being positively impacted due to the increasing demand from other therapeutic areas which include thyroid hormone therapy and growth hormone therapy as the hormone replacement therapy is comparatively safe and efficient method and is cost effective. The other benefits that are associated with the hormone replacement therapy include minimum risk incidence of cardiovascular disease, osteoporosis, and vasomotor symptoms are also reduced thus expecting to fuel the growth of hormone replacement therapy market. The limitations of the hormone replacement therapy market include the side effects that are involved in this therapy such as fluid retention, indigestion, headache, and depression thus hindering the popularity of the therapeutic area.

Request Report TOC (Table of Contents) @ https://www.zionmarketresearch.com/toc/hormone-replacement-therapy-market

Global Hormone Replacement Therapy Market: Regional Analysis

Regional diversification of the hormone replacement therapy market is given as follows Asia Pacific, Latin America, the Middle East & Africa, Western Europe, Eastern Europe, and North America. The region that is dominating the hormone replacement therapy market is North America, which is due to the fact that the U.S has the largest market owing to the popularity of the therapy among the patients that are aged 35 years and above. The factors that are contributing to the market growth in this region are increasing disposable income, early aging, and the availability of compounded drugs. In the coming years, the hormone replacement therapy market will grow speedily in Asia Pacific region owing to the increasing awareness among the people. The emerging nations such as India, Japan, and China will contribute largely to the market growth.

Browse detail report @ https://www.zionmarketresearch.com/report/hormone-replacement-therapy-market

Global Hormone Replacement Therapy Market: Competitive Players

The key market players that are involved in the hormone replacement therapy market include Pfizer, BioSante Pharmaceuticals and Amgen, Noven Pharmaceuticals, Bayer AG, Merck & co., and QuatRx Pharmaceuticals.

Inquire more before buying this report @ https://www.zionmarketresearch.com/inquiry/hormone-replacement-therapy-market

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Hormone Replacement Therapy Market: Industry Players to Show High Growth Rate by 2024 – Monotone Critic

Hormone Replacement Therapy Market: Global Industry Analysis, Size, Share, Growth, Trends, and Forecasts 2016 … – Digital Journal

Zion Market Research, the market research group announced the analysis report titled ‘Hormone Replacement Therapy Market: Global Industry Analysis, Size, Share, Growth, Trends, and Forecasts 20162024’

This press release was orginally distributed by SBWire

Sarasota, FL — (SBWIRE) — 07/27/2017 — Global Hormone Replacement Therapy Market: Overview

The medical treatment where the patients receive hormones to substitute the naturally occurring hormones with the other hormones or to add naturally occurring hormones that are absent is known as hormone replacement therapy. In the females that are at the stage of menopause, hormone replacement therapy is used to restore female hormone levels, so that the body functions normally.

Request Free Sample Report @ https://www.zionmarketresearch.com/sample/hormone-replacement-therapy-market

Global Hormone Replacement Therapy Market: Segmentation

The global hormone replacement therapy is fragmented into therapy type, distribution channel, and application. On the basis of a therapy type, the global market is segregated into estrogen replacement therapy, thyroid hormone replacement, and growth hormone replacement. The thyroid hormone replacement segment is further sub-segmented into tablets, injections, and capsules. The growth hormone replacement segment is sub-categorized into somatostatin analogs and dopamine agonist. On the basis of the distribution channel, the market is categorized into e-commerce, retail pharmacies and drugstores, hospital pharmacies, compounding pharmacies, and others. On the basis of application, the market is divided into hypothyroidism, menopause, cancer, hypopituitarism, and others.

Global Hormone Replacement Therapy Market: Growth Factors

The key factors that are driving the hormone replacement therapy market are enlarged demand for the regenerative medicines which include reproductive-cycle boosting and anti-aging. The market is being positively impacted due to the increasing demand from other therapeutic areas which include thyroid hormone therapy and growth hormone therapy as the hormone replacement therapy is comparatively safe and efficient method and is cost effective. The other benefits that are associated with the hormone replacement therapy include minimum risk incidence of cardiovascular disease, osteoporosis, and vasomotor symptoms are also reduced thus expecting to fuel the growth of hormone replacement therapy market. The limitations of the hormone replacement therapy market include the side effects that are involved in this therapy such as fluid retention, indigestion, headache, and depression thus hindering the popularity of the therapeutic area.

Request Report TOC (Table of Contents) @ https://www.zionmarketresearch.com/toc/hormone-replacement-therapy-market

Global Hormone Replacement Therapy Market: Regional Analysis

Regional diversification of the hormone replacement therapy market is given as follows Asia Pacific, Latin America, the Middle East & Africa, Western Europe, Eastern Europe, and North America. The region that is dominating the hormone replacement therapy market is North America, which is due to the fact that the U.S has the largest market owing to the popularity of the therapy among the patients that are aged 35 years and above. The factors that are contributing to the market growth in this region are increasing disposable income, early aging, and the availability of compounded drugs. In the coming years, the hormone replacement therapy market will grow speedily in Asia Pacific region owing to the increasing awareness among the people. The emerging nations such as India, Japan, and China will contribute largely to the market growth.

Browse detail report @ https://www.zionmarketresearch.com/report/hormone-replacement-therapy-market

Global Hormone Replacement Therapy Market: Competitive Players

The key market players that are involved in the hormone replacement therapy market include Pfizer, BioSante Pharmaceuticals and Amgen, Noven Pharmaceuticals, Bayer AG, Merck & co., and QuatRx Pharmaceuticals.

Inquire more before buying this report @ https://www.zionmarketresearch.com/inquiry/hormone-replacement-therapy-market

About Zion Market ResearchZion Market Research is an obligated company. We create futuristically, cutting edge, informative reports ranging from industry reports, a company reports to country reports. We provide our clients not only with market statistics unveiled by avowed private publishers and public organizations but also with Vogue and newest industry reports along with pre-eminent and niche company profiles. Our database of market research reports comprises a wide variety of reports from Cardinal industries. Our database is been updated constantly in order to fulfill our clients with prompt and direct online access to our database. Keeping in mind the client’s needs, we have included expert insights on global industries, products, and market trends in this database. Last but not the least, we make it our duty to ensure the success of clients connected to usafter allif you do well, a little of the light shines on us.

For more information on this press release visit: http://www.sbwire.com/press-releases/hormone-replacement-therapy/release-840079.htm

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Hormone Replacement Therapy Market: Global Industry Analysis, Size, Share, Growth, Trends, and Forecasts 2016 … – Digital Journal

Male Hypogonadism Market Deep Research Study with Forecast by 2025 – Digital Journal

The report presents an in-depth analysis of the global male hypogonadism market with current trends and future estimates to explain the imminent investment pockets. The quantitative analysis of the market for the forecast period from 2017 to 2025 will enable stakeholders to capitalize on the prevailing growth opportunities.

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San Francisco, CA — (SBWIRE) — 07/11/2017 — Global Male Hypogonadism Market: Snapshot

Hypogonadism in males refers to a condition in the male body where the testes show a significantly reduced level of functioning than normal. The overall result of male hypogonadism is a reduction in the rate of biosynthesis of male sex hormones. This state is more commonly known as interrupted stage 1 puberty. Hypoandrogenism, or the low androgen or testosterone level in a male can vary in severity from person to person. It is often the cause of partial or complete infertility. There are multiple forms of male hypogonadism and even more ways to classify them. Most endocrinologists commonly classify male hypogonadism on the basis of the level of defectiveness of the male reproductive system.

In many cases, doctors also measure the level of gonadotropins to classify a patient between primary and secondary male hypogonadism. Primary male hypogonadism refers to the cause of the condition being due to defective gonads. There are different types of primary male hypogonadism, including Turner syndrome and Klinefelter syndrome. Secondary male hypogonadism is caused by defects in pituitary or hypothalamic glands. They include Kallmann syndrome and hypopituitarism.

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Global Male Hypogonadism Market: Overview

Male Hypogonadism refers to a clinical condition, wherein the testes fail to produce enough testosterone leading to delayed puberty or incomplete development. The condition is related to impaired development of muscle mass, development of breast tissues, impaired body hair growth, and lack of deepening of the voice.

The male Hypogonadism market can be segmented by therapy, type, drug delivery, and geography.

The report presents an in-depth analysis of the global male hypogonadism market with current trends and future estimates to explain the imminent investment pockets. The quantitative analysis of the market for the forecast period from 2017 to 2025 will enable stakeholders to capitalize on the prevailing growth opportunities.

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Global Male Hypogonadism Market: Trends and Opportunities

The top driver of the male hypogonadism market includes rising prevalence of testosterone deficiency among men, increasing infertility rates, and increasing awareness among individuals about hypogonadism treatment due to awareness drives organized by several governments across the world. Moreover, high risk of hypogonadism among the geriatric population with obesity and diabetes, and increasing prevalence of chronic disorders among the geriatrics are further expected to boost the market’s growth.

However, factors such as high side effects of testosterone products are challenging the growth of testosterone replacement therapy market. Top players in the market are focused on research and development to introduce newer products with fewer or negligible side effects and improved results. For example, LPCN 1111, a product which is under development from Lipocine Inc., is a newer testosterone prodrug that utilizes Lip’ral technology for enhanced systemic absorption and for enhanced solubility of testosterone. Nevertheless, technological advancements are anticipated to extend new opportunities to the market’s growth.

Global Male Hypogonadism Market: Regional Overview

The global male Hypogonadism market can be analyzed with respect to the regional segments of North America, Asia Pacific, Europe, Latin America, and the Middle East and Africa. North America held the majority share of the global market in the recent past and is expected to retain its dominant position in the near future. This is mainly due to the rise in the number of individuals suffering from primary and secondary conditions of hypogonadism, and rising awareness among individuals about treatment options for the condition. Moreover, the presence of ultra-modern healthcare infrastructure and increasing popularity of technologically advanced products are expected to offer new opportunities for top players in this market. The region is closely followed by Europe.

Read Comprehensive Overview of Report@ https://www.tmrresearch.com/male-hypogonadism-market

Asia Pacific is expected to offer lucrative opportunities to this market due to the modernization of the healthcare infrastructure in the emerging economies of India and China and the increasing awareness about the treatment for the condition. In Asia Pacific, the increasing prevalence of hypogonadism and infertility rates along with the rising geriatric population base with diabetes and obesity are propelling the growth of this market. China, Taiwan, and Malaysia are some of the countries that display the highest rate of male hypogonadism.

Major Companies Mentioned in Report

Some of the key players in the male Hypogonadism market include AbbVie Inc., Astrazeneca plc, Eli Lilly and Company Ltd., Merck & Co. Inc., SA, Finox Biotech, Laboratories Genevrier, Teva Pharmaceutical Industries Ltd., Allergan plc, Bayer AG, Endo International plc, IBSA Institut Biochimque, and Ferring.

Key players are focused on product approval for growth considerations and to cater to the changing demand of the industry. The introduction of innovative and technologically advanced products is also the focus of key players to increase their market share and for serving patients in a better manner.

About TMR Research TMR Research is a premier provider of customized market research and consulting services to business entities keen on succeeding in today’s supercharged economic climate. Armed with an experienced, dedicated, and dynamic team of analysts, we are redefining the way our clients’ conduct business by providing them with authoritative and trusted research studies in tune with the latest methodologies and market trends.

Our savvy custom-built reports span a gamut of industries such as pharmaceuticals, chemicals and metals, food and beverages, and technology and media, among others. With actionable insights uncovered through in-depth research of the market, we try to bring about game-changing success for our clients.

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Male Hypogonadism Market Deep Research Study with Forecast by 2025 – Digital Journal

Treatment of hypopituitarism – uptodate.com

INTRODUCTION

Treatment of patients with hypopituitarism is the sum of the treatments of each of the individual pituitary hormonal deficiencies detected when a patient with a pituitary or hypothalamic disease is tested. The treatments of corticotropin (ACTH), thyroid-stimulating hormone (TSH), and luteinizing hormone (LH) and follicle-stimulating hormone (FSH) deficiencies are in many ways the same as the treatments of primary deficiencies of the respective target glands, but in other ways they differ. Both the similarities and differences will be highlighted below. Treatment of growth hormone (GH) deficiency is unique to hypopituitarism.

The specifics of therapy for hypopituitarism will be reviewed here. The causes, clinical manifestations, and diagnosis of hypopituitarism, as well as GH deficiency in adults and the management of individual hormone deficiencies, are reviewed in more detail elsewhere. (See “Causes of hypopituitarism” and “Clinical manifestations of hypopituitarism” and “Diagnostic testing for hypopituitarism” and “Growth hormone deficiency in adults”.)

IMPORTANCE OF TREATMENT

One reason to optimize treatment is that in a retrospective study of 344 patients who had hypopituitarism after pituitary surgery, the long-term mortality was about double that of the general population [1]. Most of the excess mortality was due to cerebrovascular disease. The relationship between the hypopituitarism and the excess mortality remains unknown, and we do not know if even optimal treatment will improve mortality.

ACTH DEFICIENCY

The primary consequence of lack of corticotropin (ACTH) is cortisol deficiency. As a result, treatment consists of the administration of hydrocortisone or other glucocorticoid in an amount and timing to mimic the normal pattern of cortisol secretion. Because there is no test to assess the adequacy of the replacement, the optimal replacement glucocorticoid and the optimal doses are not known. Most authorities recommend replacement with hydrocortisone because that is the hormone the adrenal glands make normally, but others prefer prednisone or dexamethasone for their longer durations of action.

Preparation and doseMost authorities recommend hydrocortisone doses of 15 to 25 mg/day [2,3] because those doses are similar to daily production rates [4]. Patients who are more severely deficient or weigh more tend to need doses at the upper end of this range and vice versa. Some patients, however, need even larger doses to avoid severely symptomatic adrenal insufficiency, and others can get by on smaller amounts.

Literature review current through: Apr 2017. | This topic last updated: Nov 03, 2015.

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Treatment of hypopituitarism – uptodate.com

Clinton child battles rare genetic disorder – Utica Observer Dispatch

Amy Neff Roth

Dominic Tebo has gotten a lot of love and a lot of medical care in his young life.

The Clinton 2-year old was born with an array of medical problems and has undergone many treatments. His parents put the other parts of their lives on hold for six months so they could stay in Syracuse while he remained in the neonatal intensive care unit.

Now Dominic needs one thing his parents cant afford to give him an accessible home.

My child has love. He has toys. He has everything that a 2-year-old needs, a normal two-year old. But unfortunately, I cannot give him the room to keep progressing, said Dominics mother, Monica Moffo.

So the Lake Delta Kiwanis are stepping in, hosting a fundraiser Sunday in Lee Center to raise money for the family. It will take place from noon to 5 p.m. at the Lee Center Fire Hall at 5510 School St. It will feature a chicken barbecue, live music and 50/50 and gift basket raffles. The cost is $10 per person.

Moffo and her fianc, Eric Tebo, Dominics father, lived in Lee Center before they temporarily stopped working to be with Dominic. Now they live in Clinton with Moffos mother.

Dominic has a rare gene mutation known as MAG-2. His doctor told the family that hes one of only five people in the world and the only one in the United States known to have the condition, Moffo said. Its rarity is apparent in the lack of information available through a Google search.

He has all his chromosomes and out of one of his chromosomes theres thousands of letters in a chromosome out of all of his chromosomes, hes missing one letter, Moffo explained.

Moffo said theyve been told that all the people with the mutation have respiratory problems like Dominic. But Dominic was born with a laundry list of medical conditions, many of which the others do not have, Moffo said.

Dominic was born with hypopituitarism (malfunctioning of the pituitary gland), tracheomalachia (in which the cartilage is so soft that the trachea partially collapses), clench hands, club feet, bell-shaped lungs and an enlarged tongue. He has a tracheotomy to help his breathing and had surgery on his tongue a year and a half ago. He used to be on a feeding tube, but hes able to eat on his own now.

Hes had multiple surgeries, some life threatening, and has been in and out of the hospital. Hes about to scooch around the house now and is learning to use a walker, his mother said. He also has a weakened immune system so his family tried to keep him somewhat isolated.

Its not clear if all his problems are linked to his genetic defect or if he has another medical condition as well.

They literally consider him an open book mystery, Moffo said.

Despite the challenges, Dominic has come a long way, she said.

Hes a very happy boy, she said, and always a smile, no matter what.

Follow @OD_Roth on Twitter or call her at 315-691-2961

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Clinton child battles rare genetic disorder – Utica Observer Dispatch

FDA Grants BAVENCIO (avelumab) Approval for a Common Type of Advanced Bladder Cancer – PR Newswire (press release)

ROCKLAND, Mass. and NEW YORK, May 9, 2017 /PRNewswire/ — EMD Serono, the biopharmaceutical business of Merck KGaA, Darmstadt, Germany, in the US and Canada, and Pfizer Inc. (NYSE: PFE) today announced that the US Food and Drug Administration (FDA) has approved BAVENCIO (avelumab) Injection for the treatment of patients with locally advanced or metastatic urothelial carcinoma (UC) who have disease progression during or following platinum-containing chemotherapy, or who have disease progression within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy. BAVENCIO was previously granted accelerated approval from the FDA for the treatment of adults and pediatric patients 12 years and older with metastatic Merkel cell carcinoma (MCC). These indications are approved under accelerated approval based on tumor response and duration of response. Continued approval for these indications may be contingent upon verification and description of clinical benefit in confirmatory trials.1

“This approval for BAVENCIO in patients with locally advanced or metastatic urothelial carcinoma exemplifies our unwavering commitment to finding new treatments for the most challenging cancers,” said Luciano Rossetti, M.D., Executive Vice President, Global Head of Research & Development at the biopharma business of Merck KGaA, Darmstadt, Germany. “Coming just a few weeks after the approval for metastatic Merkel cell carcinoma, we continue to demonstrate our ability to accelerate access to innovative medicines for patients in need.”

“This approval builds on the ongoing clinical development program for BAVENCIO in urothelial carcinoma and reinforces our commitment to providing new medicines to patients with difficult-to-treat cancers,” said Liz Barrett, Global President, Pfizer Oncology. “By drawing on the strength of the alliance, as well as Pfizer’s deep experience in genitourinary cancers, we believe BAVENCIO will be an important treatment option, and we hope it will help to improve outcomes for these patients.”

Bladder cancer makes up approximately 90% of urothelial carcinomas and is the sixth most common cancer in the US.2,3 When the disease has metastasized, the five-year survival rate is approximately 5%.4 Despite advances in the treatment of locally advanced or metastatic urothelial carcinoma, the prognosis for patients remains poor and more treatment options are needed.2

“Once urothelial carcinoma progresses after treatment with chemotherapy, the five-year survival rate is alarmingly low,” said Dr. Andrea Apolo, National Cancer Institute, Bethesda, MD, US. “Until recently, there had been limited innovation in urothelial carcinoma, and this approval gives us another treatment to help battle this aggressive disease.”

The efficacy and safety of BAVENCIO was demonstrated in the urothelial carcinoma cohorts (N=242) of the JAVELIN Solid Tumor trial, a Phase I, open-label, single-arm, multicenter study of BAVENCIO in the treatment of various solid tumors. The urothelial carcinoma cohorts enrolled patients with locally advanced or metastatic urothelial carcinoma with disease progression on or after platinum-containing chemotherapy or who had disease progression within 12 months of treatment with a platinum-containing neoadjuvant or adjuvant chemotherapy regimen. These data will be presented at an upcoming medical congress.

The warnings and precautions for BAVENCIO include immune-mediated adverse reactions (such as pneumonitis, hepatitis, colitis, endocrinopathies, nephritis and renal dysfunction and other adverse reactions), infusion-related reactions and embryo-fetal toxicity. The most common adverse reactions (reported in at least 20% of patients) in patients with locally advanced or metastatic urothelial carcinoma were fatigue (41%), infusion-related reaction (30%), musculoskeletal pain (25%), nausea (24%), decreased appetite/hypophagia (21%) and urinary tract infection (21%).1 For more information, please see Important Safety Information for BAVENCIO below.

BAVENCIO is designed to potentially engage both the adaptive and innate immune systems. By binding to PD-L1, BAVENCIO is thought to prevent tumor cells from using PD-L1 for protection against white blood cells, such as T cells, exposing them to anti-tumor responses.1 BAVENCIO has also been shown to induce antibody-dependent cell-mediated cytotoxicity (ADCC) in vitro.1

The alliance is committed to providing industry-leading patient access and reimbursement support through its CoverOne program. This program provides a spectrum of patient access and reimbursement support services intended to help patients receive appropriate access to BAVENCIO in the United States. CoverOne may be reached by phone at 844-8COVER1 (844-826-8371) or online at http://www.CoverOne.com.

About Urothelial Carcinoma Cohorts in JAVELIN Solid Tumor Trial The efficacy and safety of BAVENCIO was demonstrated in the urothelial carcinoma cohorts of the JAVELIN Solid Tumor trial, a Phase I, open-label, single-arm, multicenter study that included 242 patients with locally advanced or metastatic urothelial carcinoma with disease progression on or after platinum- containing chemotherapy or who had disease progression within 12 months of treatment with a platinum-containing neoadjuvant or adjuvant chemotherapy regimen who were treated with BAVENCIO.

Patients with active or a history of central nervous system metastasis; other malignancies within the last five years; an organ transplant; conditions requiring therapeutic immune suppression; or active infection with HIV, hepatitis B or C were excluded. Patients with autoimmune disease, other than type 1 diabetes, vitiligo, psoriasis, or thyroid disease that did not require immunosuppressive treatment, were excluded. Patients were included regardless of their PD-L1 status. Patients received BAVENCIO at a dose of 10 mg/kg intravenously over 60 minutes every two weeks until disease progression or unacceptable toxicity. Tumor response assessments were performed every six weeks, as assessed by an Independent Endpoint Review Committee (IERC) using Response Evaluation Criteria in Solid Tumors (RECIST) v1.1. Efficacy outcome measures included confirmed overall response rate, (ORR) and duration of response (DOR). Efficacy measures were evaluated in patients who were followed for a minimum of both 13 weeks and 6 months at the time of data cut-off.

Out of the total 226 patients evaluable for efficacy, 44% had non-bladder urothelial carcinoma, including 23% of patients with upper tract disease; 83% of patients had visceral metastases; 34% of patients had liver metastases. Nine patients (4%) had disease progression following prior platinum-containing neoadjuvant or adjuvant therapy only. Forty-seven percent of patients only received prior cisplatin-based regimens, 32% received only prior carboplatin-based regimens, and 20% received both cisplatin and carboplatin-based regimens.

The international clinical development program for avelumab, known as JAVELIN, involves more than 30 clinical programs, including nine Phase III trials, and more than 5,200 patients across more than 15 tumor types.

In December 2015, Merck KGaA, Darmstadt, Germany and Pfizer announced the initiation of a Phase III multicenter, multinational, randomized, open-label, parallel-arm study (JAVELIN Bladder 100) of BAVENCIO plus best supportive care versus best supportive care alone as a maintenance treatment in patients with locally advanced or metastatic urothelial carcinoma whose disease did not progress after completion of first-line platinum-containing chemotherapy. This trial is currently enrolling patients.

For more information about JAVELIN trials, please visit http://www.clinicaltrials.gov.

For full prescribing information and medication guide for BAVENCIO, please see http://www.BAVENCIO.com.

IMPORTANT SAFETY INFORMATION and INDICATIONS

BAVENCIO can cause immune-mediated pneumonitis, including fatal cases. Monitor patients for signs and symptoms of pneumonitis and evaluate suspected cases with radiographic imaging. Administer corticosteroids for Grade 2 or greater pneumonitis. Withhold BAVENCIO for moderate (Grade 2) and permanently discontinue for severe (Grade 3), life-threatening (Grade 4), or recurrent moderate (Grade 2) pneumonitis. Pneumonitis occurred in 1.2% (21/1738) of patients, including one (0.1%) patient with Grade 5, one (0.1%) with Grade 4, and five (0.3%) with Grade 3.

BAVENCIO can cause immune-mediated hepatitis, including fatal cases. Monitor patients for abnormal liver tests prior to and periodically during treatment. Administer corticosteroids for Grade 2 or greater hepatitis. Withhold BAVENCIO for moderate (Grade 2) immune-mediated hepatitis until resolution and permanently discontinue for severe (Grade 3) or life-threatening (Grade 4) immune-mediated hepatitis. Immune-mediated hepatitis was reported in 0.9% (16/1738) of patients, including two (0.1%) patients with Grade 5 and 11 (0.6%) with Grade 3.

BAVENCIO can cause immune-mediated colitis. Monitor patients for signs and symptoms of colitis. Administer corticosteroids for Grade 2 or greater colitis. Withhold BAVENCIO until resolution for moderate or severe (Grade 2 or 3) colitis and permanently discontinue for life-threatening (Grade 4) or recurrent (Grade 3) colitis upon re-initiation of BAVENCIO. Immune-mediated colitis occurred in 1.5% (26/1738) of patients, including seven (0.4%) with Grade 3.

BAVENCIO can cause immune-mediated endocrinopathies, including adrenal insufficiency, thyroid disorders, and type 1 diabetes mellitus.

Monitor patients for signs and symptoms of adrenal insufficiency during and after treatment, and administer corticosteroids as appropriate. Withhold BAVENCIO for severe (Grade 3) or life-threatening (Grade 4) adrenal insufficiency. Adrenal insufficiency was reported in 0.5% (8/1738) of patients, including one (0.1%) with Grade 3.

Thyroid disorders can occur at any time during treatment. Monitor patients for changes in thyroid function at the start of treatment, periodically during treatment, and as indicated based on clinical evaluation. Manage hypothyroidism with hormone replacement therapy and hyperthyroidism with medical management. Withhold BAVENCIO for severe (Grade 3) or life- threatening (Grade 4) thyroid disorders. Thyroid disorders including hypothyroidism, hyperthyroidism, and thyroiditis were reported in 6% (98/1738) of patients, including three (0.2%) with Grade 3.

Type 1 diabetes mellitus including diabetic ketoacidosis: Monitor patients for hyperglycemia or other signs and symptoms of diabetes. Withhold BAVENCIO and administer anti-hyperglycemics or insulin in patients with severe or life-threatening (Grade 3) hyperglycemia, and resume treatment when metabolic control is achieved. Type 1 diabetes mellitus without an alternative etiology occurred in 0.1% (2/1738) of patients, including two cases of Grade 3 hyperglycemia.

BAVENCIO can cause immune-mediated nephritis and renal dysfunction. Monitor patients for elevated serum creatinine prior to and periodically during treatment. Administer corticosteroids for Grade 2 or greater nephritis. Withhold BAVENCIO for moderate (Grade 2) or severe (Grade 3) nephritis until resolution to Grade 1 or lower. Permanently discontinue BAVENCIO for life-threatening (Grade 4) nephritis. Immune-mediated nephritis occurred in 0.1% (1/1738) of patients.

BAVENCIO can result in other severe and fatal immune-mediated adverse reactions involving any organ system during treatment or after treatment discontinuation. For suspected immune-mediated adverse reactions, evaluate to confirm or rule out an immune-mediated adverse reaction and to exclude other causes. Depending on the severity of the adverse reaction, withhold or permanently discontinue BAVENCIO, administer high-dose corticosteroids, and initiate hormone replacement therapy if appropriate. Resume BAVENCIO when the immune-mediated adverse reaction remains at Grade 1 or lower following a corticosteroid taper. Permanently discontinue BAVENCIO for any severe (Grade 3) immune-mediated adverse reaction that recurs and for any life-threatening (Grade 4) immune-mediated adverse reaction. The following clinically significant immune-mediated adverse reactions occurred in less than 1% of 1738 patients treated with BAVENCIO: myocarditis with fatal cases, myositis, psoriasis, arthritis, exfoliative dermatitis, erythema multiforme, pemphigoid, hypopituitarism, uveitis, Guillain-Barr syndrome, and systemic inflammatory response.

BAVENCIO can cause severe (Grade 3) or life-threatening (Grade 4) infusion-related reactions. Patients should be premedicated with an antihistamine and acetaminophen prior to the first 4 infusions and for subsequent doses based upon clinical judgment and presence/severity of prior infusion reactions. Monitor patients for signs and symptoms of infusion-related reactions, including pyrexia, chills, flushing, hypotension, dyspnea, wheezing, back pain, abdominal pain, and urticaria. Interrupt or slow the rate of infusion for mild (Grade 1) or moderate (Grade 2) infusion-related reactions. Permanently discontinue BAVENCIO for severe (Grade 3) or life-threatening (Grade 4) infusion-related reactions. Infusion-related reactions occurred in 25% (439/1738) of patients, including three (0.2%) patients with Grade 4 and nine (0.5%) with Grade 3.

BAVENCIO can cause fetal harm when administered to a pregnant woman. Advise patients of the potential risk to a fetus including the risk of fetal death. Advise females of childbearing potential to use effective contraception during treatment with BAVENCIO and for at least 1 month after the last dose of BAVENCIO. It is not known whether BAVENCIO is excreted in human milk. Advise a lactating woman not to breastfeed during treatment and for at least 1 month after the last dose of BAVENCIO due to the potential for serious adverse reactions in breastfed infants.

The most common adverse reactions (all grades, 20%) in patients with metastatic Merkel cell carcinoma (MCC) were fatigue (50%), musculoskeletal pain (32%), diarrhea (23%), nausea (22%), infusion-related reaction (22%), rash (22%), decreased appetite (20%), and peripheral edema (20%).

Selected treatment-emergent laboratory abnormalities (all grades, 20%) in patients with metastatic MCC were lymphopenia (49%), anemia (35%), increased aspartate aminotransferase (34%), thrombocytopenia (27%), and increased alanine aminotransferase (20%).

The most common adverse reactions (all grades, 20%) in patients with locally advanced or metastatic urothelial cancer (UC) were fatigue (41%), infusion-related reaction (30%), musculoskeletal pain (25%), nausea (24%), decreased appetite/hypophagia (21%) and urinary tract infection (21%).

Selected laboratory abnormalities (grades 3-4, 3%) in patients with locally advanced or metastatic UC were hyponatremia (16%), gamma-glutamyltransferase increased (12%), lymphopenia (11%), hyperglycemia (9%), increased alkaline phosphatase (7%), anemia (6%), increased lipase (6%), hyperkalemia (3%), and increased aspartate aminotransferase (3%).

INDICATIONS

BAVENCIO is indicated for the treatment of adults and pediatric patients 12 years and older with metastatic Merkel cell carcinoma (MCC).

BAVENCIO is indicated for the treatment of patients with locally advanced or metastatic urothelial carcinoma (UC) who have disease progression during or following platinum-containing chemotherapy or have disease progression within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy.

These indications are approved under accelerated approval based on tumor response and duration of response. Continued approval for these indications may be contingent upon verification and description of clinical benefit in confirmatory trials.

Please see full Prescribing Information and Medication Guide.

Avelumab has not yet been approved for any indication in any market outside of the US. As announced on October 31, 2016, the European Medicines Agency (EMA) has validated for review Merck KGaA, Darmstadt, Germany’s Marketing Authorization Application for avelumab, for the proposed indication of metastatic Merkel cell carcinoma.

About BAVENCIO (avelumab) BAVENCIO is a human programmed death ligand-1 (PD-L1) blocking antibody indicated in the US for the treatment of patients with locally advanced or metastatic urothelial carcinoma who have disease progression during or following platinum-containing chemotherapy or who have disease progression within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy, as well as for the treatment of adults and pediatric patients 12 years and older with metastatic Merkel cell carcinoma.1 These indications are approved under accelerated approval based on tumor response and duration of response. Continued approval for these indications is contingent upon verification and description of clinical benefit in confirmatory trials.

BAVENCIO is not approved for any indication in any market outside the US.

Alliance between Merck KGaA, Darmstadt, Germany, and Pfizer Inc., New York, US Immuno-oncology is a top priority for Merck KGaA, Darmstadt, Germany and Pfizer Inc. The global strategic alliance between Merck KGaA, Darmstadt, Germany, and Pfizer Inc., New York, US, enables the companies to benefit from each other’s strengths and capabilities and further explore the therapeutic potential of avelumab, an anti-PD-L1 antibody initially discovered and developed by Merck KGaA, Darmstadt, Germany. The immuno-oncology alliance will jointly develop and commercialize avelumab and advance Pfizer’s PD-1 antibody. The alliance is focused on developing high-priority international clinical programs to investigate avelumab as a monotherapy, as well as in combination regimens, and is striving to find new ways to treat cancer.

About EMD Serono, Inc. EMD Serono is the biopharmaceutical business of Merck KGaA, Darmstadt, Germany a leading science and technology company in the US and Canada focused exclusively on specialty care. For more than 40 years, the business has integrated cutting-edge science, innovative products and industry-leading patient support and access programs. EMD Serono has deep expertise in neurology, fertility and endocrinology, as well as a robust pipeline of potential therapies in oncology, immuno-oncology and immunology as R&D focus areas. Today, the business has 1,200 employees around the country with commercial, clinical and research operations based in the company’s home state of Massachusetts. http://www.emdserono.com

About Merck KGaA, Darmstadt, Germany All Merck KGaA, Darmstadt, Germany Press Releases are distributed by e-mail at the same time they become available on the Merck KGaA, Darmstadt, Germany Website. Please go to http://www.emdgroup.com/subscribe to register online, change your selection or discontinue this service.

Merck KGaA, Darmstadt, Germany, is a leading science and technology company in healthcare, life science and performance materials. Around 50,000 employees work to further develop technologies that improve and enhance life from biopharmaceutical therapies to treat cancer or multiple sclerosis, cutting-edge systems for scientific research and production, to liquid crystals for smartphones and LCD televisions. In 2016, Merck KGaA, Darmstadt, Germany, generated sales of 15.0 billion in 66 countries.

Founded in 1668, Merck KGaA, Darmstadt, Germany, is the world’s oldest pharmaceutical and chemical company. The founding family remains the majority owner of the publicly listed corporate group. Merck KGaA, Darmstadt, Germany, holds the global rights to the “Merck” name and brand except in the United States and Canada, where the company operates as EMD Serono, MilliporeSigma and EMD Performance Materials.

Pfizer Inc.: Working together for a healthier world At Pfizer, we apply science and our global resources to bring therapies to people that extend and significantly improve their lives. We strive to set the standard for quality, safety and value in the discovery, development and manufacture of health care products. Our global portfolio includes medicines and vaccines as well as many of the world’s best-known consumer health care products. Every day, Pfizer colleagues work across developed and emerging markets to advance wellness, prevention, treatments and cures that challenge the most feared diseases of our time. Consistent with our responsibility as one of the world’s premier innovative biopharmaceutical companies, we collaborate with health care providers, governments and local communities to support and expand access to reliable, affordable health care around the world. For more than 150 years, we have worked to make a difference for all who rely on us. We routinely post information that may be important to investors on our website at http://www.pfizer.com. In addition, to learn more, please visit us on http://www.pfizer.com and follow us on Twitter at @Pfizer and @PfizerNews, LinkedIn, YouTube and like us on Facebook at Facebook.com/Pfizer.

Pfizer Disclosure Notice The information contained in this release is as of May 9, 2017. Pfizer assumes no obligation to update forward-looking statements contained in this release as the result of new information or future events or developments.

This release contains forward-looking information about BAVENCIO (avelumab), the alliance between Merck KGaA, Darmstadt, Germany and Pfizer involving anti-PD-L1 and anti-PD-1 therapies, and clinical development plans, including their potential benefits, that involves substantial risks and uncertainties that could cause actual results to differ materially from those expressed or implied by such statements. Risks and uncertainties include, among other things, uncertainties regarding the commercial success of BAVENCIO; the uncertainties inherent in research and development, including the ability to meet anticipated clinical study commencement and completion dates and regulatory submission dates, as well as the possibility of unfavorable study results, including unfavorable new clinical data and additional analyses of existing clinical data; risks associated with interim data; the risk that clinical trial data are subject to differing interpretations, and, even when we view data as sufficient to support the safety and/or effectiveness of a product candidate, regulatory authorities may not share our views and may require additional data or may deny approval altogether; whether and when drug applications may be filed in any other jurisdictions for the Indication or in any jurisdictions for any other potential indications for BAVENCIO, combination therapies or other product candidates; whether and when any such applications (including the pending application for BAVENCIO for metastatic Merkel cell carcinoma in the EU) may be approved by regulatory authorities, which will depend on the assessment by such regulatory authorities of the benefit-risk profile suggested by the totality of the efficacy and safety information submitted; decisions by regulatory authorities regarding labeling and other matters that could affect the availability or commercial potential of BAVENCIO, combination therapies or other product candidates; and competitive developments.

A further description of risks and uncertainties can be found in Pfizer’s Annual Report on Form 10-K for the fiscal year ended December 31, 2016, and in its subsequent reports on Form 10-Q, including in the sections thereof captioned “Risk Factors” and “Forward-Looking Information and Factors That May Affect Future Results”, as well as in its subsequent reports on Form 8-K, all of which are filed with the U.S. Securities and Exchange Commission and available at http://www.sec.gov and http://www.pfizer.com.

References

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FDA Grants BAVENCIO (avelumab) Approval for a Common Type of Advanced Bladder Cancer – PR Newswire (press release)

Radiation Tx for Persistent Acromegaly Safe, Effective – MedPage Today

Action Points

AUSTIN — Following pituitary surgery, radiation for persistent or recurrent acromegaly was shown to be an effective and safe treatment, researchers reported here.

In a retrospective analysis, patients with acromegaly who had undergone pituitary surgery and then received radiation therapy had twice the remission rate seen in those who did not receive radiation (RR 2.1, 95% CI 1.1-4.3, P=0.036), according to Diane Donegan, MD BCh BAO, senior clinical fellow of the Mayo Clinic, and colleagues.

The study reported that patients who underwent radiation treatment and those who did not did not have any significant differences in the requirement for adjuvant medical therapy at the end of the study (38/66 versus 18/28, P=0.5).

The findings of the single-center study were presented at the American Association of Clinical Endocrinologists’ annual meeting.

“As many of you know, acromegaly is most commonly due to somatotroph adenoma, and is associated with increased morbidity, mortality, and decreased quality of life, if uncontrolled,” Donegan explained during an oral presentation. “If IGF-1 and growth hormone is normalized, then mortality can be similar to the general population.”

In order to address this, Donegan noted her research group aimed to assess the outcomes, as well as complications associated with radiation treatment, which is currently considered the third-line therapy for chronic acromegaly. Donegan said radiation treatment is not currently a very common form of treatment, particularly due to associated risk factors, such as cerebrovascular complications and hypopituitarism.

The study included individuals who were diagnosed with acromegaly and failed to achieve remission with surgical treatment. A total of 139 patients were included, who all underwent pituitary surgery, but continued to have abnormal IGF-I levels post-surgery.

Over half of participants underwent radiation treatment (65%, 90 of 139), with the majority exposed to Gamma Knife radiosurgery (86%). After a minimum of six-months following radiation treatment, patients experienced a mean time of 26 month to remission (6 to 223 months).

The groups did differ, Donegan said: the radiation treatment group had significantly larger tumors than those who did not undergo radiation (2 0.9 cm vs 1.4 0.6 cm, P0.001). Similarly, radiation-treated patients had a significantly higher incidence of cavernous sinus invasion (60% vs 22%, P=

There were no significant differences for risk of death between both participant groups (P=0.5), although Donegan said there were eight deaths reported throughout the duration of the trial. Other adverse events reported included one instance of stroke in the radiation group, although it was not thought to be due to the treatment.

However, Donegan suggested it is important to consider that “there is a possibility of developing anterior pituitary deficits, which needs to be borne in mind when thinking of the treatment algorithm for individual recurrent or persistent acromegaly.” She reported there was an elevated rate of development of new anterior pituitary hormonal deficit without a notable previous history of dysfunction before radiation (28 patients, 33%), most common being adrenal insufficiency.

When a member of the audience inquired about what methods were used to assess participants who developed ACTH deficiency during the study, Donegen responded they did not conduct formal insulin tolerance tests, and instead, analyzed samples of the participants cortisol.

2017-05-04T17:37:52-0400

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Radiation Tx for Persistent Acromegaly Safe, Effective – MedPage Today

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