ADDITIONAL CLINICAL CASE ENDOCRINE SYSTEM A 49 year old man develops in a course

Question

ADDITIONAL CLINICAL CASE ENDOCRINE SYSTEM A 49 year old man develops in a course of 6-12 months the following symptoms: .6-12 months prior developed impotence . His muscle endurance decreased Fatigue and his daily sleep requirement increased from 6 to 12 hours .Intolerant to cold temperatures Increased thirst, drinking 1 gallon each night Urinating up to 16 times Anorexia with no interest in food Lost 22 lb. over 3 weeks . Questions 1. Deficiency of which pituitary hormones can cause the following abnormalities seen in this patient? 2. What the presence of ADH deficiency suggests? 3. Where the lesion is located

Explanation / Answer

A) Deficiency of Vasopressin or Anti Diuretic hormone, Adrenocorticotropic hormone, Follicular stimulating hormone, Leutinizing hormone, Growth hormone and Throid stimulating hormone can cause the given symptoms.

Impotence was due to decreased LH and FSH, due to which testosterone levels fall and spermatofesperm was reduced.

Fatigue and refuced muscle endurance could be due to low levels of Growth hormone, TSH, ADH, ACTH which led to increased consumption of body glucose and reduced ability of muscles due to less ATP.

Intolerance to cold is mainly due to low TSH. Because thyroid hormones help to maintain normal body temperature.

Increased thirst and urinating frequency could have been due to any of the above listed hormones mainly ADH, GH & TSH. Because they help in maintaining normal reabsorption and secretion of electrolytes through kidney and their low levels can disturb the mechanism leading to symptoms given.

Anorexia and weight loss can be due to low GH, ADH, ACTH.

2) ADH deficiency is siggested by increased urine output ( due to low plasma osmolarity leading to Diabetes Insipidus) and increased thirst, fatigueability, reduced muscle endaevors.

3) the lesion could be located in pituitary gland eg, pituitary adenoma which compresses pituitary gland and leads to suppression of hormones.

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