APITUITARISM (apituitarismus; lat. ab from, away + pituita slime; (synonym panhypopituitarism) — the disease caused by full loss of triple functions of a hypophysis (glandula pituitaria) as a result of its inborn lack or destruction of a front share at pathological processes (acquired And.).
An etiology, a pathogeny
In a basis And. insufficiency of somatotropic, corticotropic, thyritropic and gonadotropic functions lies hypophysis (see) which are carried out by its front share — an adenohypophysis.
Acquired And. is a consequence of inflammatory changes of a hypophysis, the tumor or cyst causing an atrophy of its secretory cells, a puerperal ischemic necrosis of a hypophysis, operational removal of a hypophysis at treatment of tumors of a brain, damage of a hypophysis at tuberculosis, syphilis, etc. More often the disease develops at women in a puerperal period as a result of an ischemic necrosis of a hypophysis (see. Shikhena syndrome ).
Inborn And. it is shown at the children who were born with hypo - or an aplasia of a hypophysis. A growth inhibition, sexual development, signs of functional insufficiency of a thyroid gland and bark of adrenal glands, the general block, the dry, flabby, pigmented skin, reduced resilience to an infection are characteristic.
Patients with acquired And. are slow-moving, indifferent to surrounding, quickly get tired; weight loss, the expressed xanthopathy is noted. At inspection tendency to hypotonic, hypoglycemic and hyper thermal reactions, sharply hypersensitivity to insulin is found.
Developing sometimes at the end of a disease pituitary cachexia (see) does not belong to the category of obligatory manifestations
of A. A. it is necessary to differentiate from neurogenic anorexia (see), with diencephalic disturbances owing to tumors and injuries of a brain (see. Hypothalamic syndrome ), at which there is no arrest of development of secondary sexual characteristics, a xanthopathy, there are no signs of hypersensitivity to insulin.
Treatment consists in systematic introduction of AKTG, somatotropic hormone, Thyreoidinum, sex hormones (estrogen, androgens), a hydrocortisone, DOCK. At the first stage the hormonal drugs replacing insufficiency of numerous functions of peripheral closed glands are used. At the second stage, after compensation of a lose of weight of a body and recovery of exchange balance, appoint the stimulating triple hormones which should be applied with care. At co-administration of glucocorticoids and androgens (or estrogen) it is necessary to reduce a dose of derivatives of a hydrocortisone.
Prevention includes actions for fight against the main etiological moments.
Bibliography: Shereshevsky N. A. Clinical endocrinology, M., 1957; M. and Hollo I Yules. Diagnosis and pathophysiological bases of nevroendo-krshchshy diseases, the lane with Wenger., Budapest, 1967; Sturm A. R. Grundbegriffe der inneren Medizin, Stuttgart, 1965.
BB. E. Veltishchev.