1. Hipopituitarismo Dra Mirtha Guitelman División Endocrinología Htal Carlos G Durand Buenos Aires [email_address]
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10. Hipoplasia de la Adenohipofisis Y Lobulo post ectopico Hipoplasia de Nervio Optico Mutation of HESX1 Causing Pituitary and Optic Nerve Hypoplasia and Combined Pituitary Hormone Deficiency in a Japanese Patient The Journal of Clinical Endocrinology & Metabolism Vol. 88, No. 1 45-50
11. A Familial Form of Congenital Hypopituitarism Due to a PROP1 Mutation in a Large Kindred: Phenotypic and in Vitro Functional Studies The Journal of Clinical Endocrinology & Metabolism 89(11):5779–5786
13. We report the natural history of a hypopituitarism in a large Tunisian kindred including 29 subjects from the same consanguineous family. The index case was a 9-yr-old girl with severe growth retardation due to completeGH deficiency and partial corticotroph, lactotroph, and thyrotroph deficiencies. Magnetic resonance imaging showed a hyperplastic anterior pituitary. Thirteen of the 28 relatives examined (10 female subjects) had hypopituitarism. In the 14 patients, previously untreated (aged 6–53 yr), height was 5.7 1.7 SD score, and puberty was spontaneously initiated in only two females. Complete GH deficiency was found in all 12 patients investigated, of whom 11 had thyrotroph and eight of 10 had corticotroph deficiency. A homozygous R73C mutation of PROP1 was present in all 10 patients studied, and a heterozygous mutation was found in six unaffected parents or siblings. In vitro the mutant had 11.5% of the transactivation capacity of the wild type and was unable to bind to a high-affinity DNA sequence. This report showed the deleterious effect of the recessive R73C mutation that affects a hot spot of the PROP1 gene and was associated with severe dwarfism, a lack of spontaneous puberty, and a high incidence of early onset of corticotroph deficiency. ( J Clin Endocrinol Metab 89: 5779–5786,
28. Traumatic Brain Injury TBI La Injuria cerebral tanto traumática (TBI) , como la hemorragia subaracnoidea (SAH) han sido reconocidas como causales de Hipopituitarismo Estudios recientes estiman que 15-50% de los pacientes que tienen BI pueden desarrollar algún grado de Insuficiencia hipofisaria
42. Mujer 42 años. 4/03 M de C : polidipsia y poliuria ( ~ 6 litros). Cansancio, intolerancia al frío, piel seca, constipación. Rodete positivo, impronta dentaria, piel seca, amarillenta y fría. No hipotensión ortostática. AP: Cx ca de mama hace 3 años TAC cerebro normal. Campo visual: normal FSH:<1,2 ng/ml LH:<0,9ng/ml E2 : <28 ng/ml TSH:1 uUI/ml T4: 4ng/ml T4L: < 0,5 ng/ml Cortisol : <5 post ACTH : 14ng/ml
68. Monitoreo de Reemplazo corticoideo Clinical Endocrinology 61 (3), 367–375. Dosis de hidrocortisona Según peso corporal
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74. Hipogonadismo Hipogonadotrófico masculino Tratamiento Niveles estables/ Frecuencia 3 meses IM 1000 mg / 3 meses Undecanoato de Testo olor desagradable, contacto pareja. TD 5-10 mg/ 24 hs GEL Niveles estables de To Irritación piel, prurito, 10% discontinuación TD 2,5 mg/24 hs Parches no escrotales Niveles estables de To Depilación de zona TD 5 mg/ 24 hs Parches escrotales Pico 24 hs no fisiológico Ginecomastia, agresividad, policitemia IM 250 mg/ 2- 4 sem Enantato de To Ventajas/ Desventajas Via adm Dosis Droga
94. “ La mejor manera de detectar pacientes con Hipopit es tener un elevado nivel de sospecha” Es nuestra responsabilidad educar y enseñar no solo a los endocrinologos , sino tambien a terapistas , neurólogos , y médicos clínicos
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