Endocrine system Disorders
Disoder Causes
Gigantism caused by a typically benign tumor or adenoma in
the anterior pituitary gland. That tumor causes excess or
oversecretion of growth hormone production.
A. Gigantism and Dwarfism
dwarfism
 Undersecretion of growth hormone in the anterior
pituitary gland.
 Dwarfism has other causes, including metabolic or
hormonal disorders in infancy or childhood.
People with dwarfism can be treated with growth hormone.
 Insertion of a shunt to drain excess fluid and relieve
pressure on the brain, tracheotomy, corrective
surgeries, surgery to remove tonsils or adenoids to
improve breathing problems related to large tonsils,
small facial structures, and/or a small chest and surgery
to widen the spinal canal (the opening through which
the spinal cord passes) to relieve spinal cord
compression.
Diabetes mellitus is a group of metabolic diseases in which the
person has high blood glucose (blood sugar) level either due to
inadequate insulin production or because the body’s cells do not
respond properly to insulin or both are the main causes.
B. Diabetes mellitus Type 1 diabetes: It is due to the body’s malfunction to produce
insulin in the body, and requires the person to inject insulin. This
form was previously referred to as “Insulin-Dependent Diabetes
Mellitus” (IDDM) or “Juvenile Diabetes”.
Type 2 diabetes: It is due to insulin resistance, a condition in
which cells fail to use insulin properly, sometimes combined with
an absolute insulin deficiency. This form was previously referred
to as non insulin-dependent diabetes mellitus (NIDDM) or “adult-
onset diabetes”.
Treatment
Surgery: Removing the tumor is the preferred
treatment for gigantism if it’s the underlying
cause.
Medication:
 Bromocriptine and cabergoline are
drugs that can be used to lower growth
hormone levels.
 Octreotide is a synthetic hormone that,
when injected, can also lower the levels
of growth hormones and IGF-1.
 Pegvisomant is a drug that blocks the
effects of growth hormones.
Dwarfism other treatment:
 Physical therapy to strengthen muscles
and increase joint range of motion
 Back braces to improve curvature of the
spine
 Placement of draining tubes in the
middle ear to help prevent hearing loss
due to repeated ear infections.
 Orthodontic treatment to relieve
crowding of teeth caused by a small jaw
 Nutritional guidance and exercise to
help prevent obesity, which can
aggravate skeletal problems
 No cure for diabetes
 Insulin: Type 1 diabetes is generally
treated with combinations of regular
and NPH (neutral protamine Hagedorn)
insulin or synthetic insulin analogs.
 When insulin is used in type 2 diabetes,
a long-acting formulation is usually
added initially while continuing oral
medications.
 Treatment of coexisting medical
conditions (high blood pressure,
dyslipidemia etc.)
 Lifestyle measures
 Regular exercise
 Proper diet
 No smoking
 No alcohol
  Pancreas transplantation
 Insulin administration

Treatment for this condition is designed to help

Hypoparathyroidism is a rare condition that occurs when the
parathyroid glands in the neck don’t produce enough parathyroid
hormone (PTH). Caused by abnormal parathyroid development,
destruction of parathyroid glands, and Vit. D deficiency. Results
in decrease blood calcium levels and increase phosphate levels.
Causes of hypoparathyroidism include:
C.Hypoparathyroidism/
 Injury to or removal of the parathyroid glands
Hyperparathyroidism  DiGeorge syndrome, which is a genetic disorder that
affects development of certain body systems
 genetics
 autoimmune disease
 cancer radiation treatments
 low magnesium levels
Hyperparathyroidism, overactive and makes excess PTH. This
could be due to a tumor, gland enlargement, or other structural
problems of the parathyroid glands.
When your calcium levels are too low, your parathyroid glands
respond by increasing the production of PTH. This causes your
kidneys and intestines to absorb a larger amount of calcium. It
also removes more calcium from your bones. PTH production
returns to normal when your calcium level goes up again.
Medications to treat hyperparathyroidism include the following:
restore the proper levels of calcium and minerals.
 Initial treatment involves taking calcium
carbonate, potassium, magnesium,
parathyroid hormone and vitamin D
supplements in pill form. Vitamin D is
given because it helps the body absorb
calcium and eliminate phosphorus.
 Calcium gluconate/ calcium chloride
given IV and aluminum hydroxide/
aluminum carbonate PO after meals to
promote excretion.
 Diet should be rich in calcium and low in
phosphorus.
 Drinking six to eight glasses of water per
day may also help ensure that your body
doesn’t lose necessary nutrients and
calcium-rich foods
Surgery: surgeon will remove only those glands
that are enlarged or have a tumor (adenoma).
 Parathyroidectomy monitor for tetany
and ensure airway pattern.
Medications to treat hyperparathyroidism include
the following:

• A calcimimetic is a drug that mimics calcium circulating in the  Hormone replacement therapy. For
blood. The drug may trick the parathyroid glands into releasing women who have gone through
less parathyroid hormone. menopause and have signs of
osteoporosis, hormone replacement
• Cinacalcet to treat hyperparathyroidism caused by chronic therapy. Note: Prolonged use of
kidney disease or parathyroid cancer. hormone replacement therapy can
increase the risk of blood clots and
breast cancer.
 Bisphosphonates also prevent the loss of
calcium from bones and may lessen
osteoporosis caused by
hyperparathyroidism.

Hyperthyroidism excessive synthesis and secretion of thyroid Medications:

hormones thyroxine (T4) and triiodothyronine (T3). May result
from inflammation after irradiation of the thyroid gland or  Antithyroid agents, Interfere with the
excessive administration of thyroid hormone without close synthesis of thyroid hormone
D. Hyperthyroidism / medication stopped 4-7 days before
hypothyroidism monitoring.
treatment.
Hypothyroidism- deficiency of thyroid hormone.  Proprythiouracil (PTU) for 4-6 weeks
before surgery.
 Primary problem arises of dysfunction solely of the
 Methimazole (Tapazole) given 4-6
thyroid.
weeks prior to administration
radioactive Iodine, stopped 3days
  Secondary if the thyroid gland is not stimulated to before and restarted 3 days after
produce normally or if target cells is failed to response administering radioactive iodine, then
normal thyroid function. tapered over 4-6 weeks.
 Amiodarone hydrochloride (Cardone)
-Autoimmune disease. Hashimoto's thyroiditis have the most must observe not to be given with sever
common cause of hypothyroidism. Autoimmune disorders occur vomiting or diarrhea.
when your immune system produces antibodies that attack your  Radiation therapy of the thyroid gland
own tissues. external radiation to the neck.
- Treatment for hyperthyroidism anti-thyroid medications to  Beta blockers symptomatic relief.
reduce and normalize their thyroid function.
Surgery
- Thyroid surgery. Removing all or a large portion of your thyroid
 Removal of thyroid gland but a total
gland can diminish or halt hormone production.
thyroidectomy may performed.
- Radiation therapy affect thyroid gland may lead to  Tracheotomy tray or endotracheal tubes
hypothyroidism. are kept ready available at clients
bedside in case of respiratory
- Congenital disease present at birth, causes cretinism and emergency.
hypotonia.
Diet
- Iodine deficiency and pituitary disorder due to tumor or failure
to product enough TSH.  Increased protein, vitamins esp. Vit. B, C
and minerals about 4,000 to 5,000
calories per day. Encourage more fluid
intake and avoid caffeine.
Diet
Medication Hypothyroidism
 High protein, high fiber, low calorie diet. Avoid foods
high in Iodine and food can interfere with thyroid  Thyroid replacement therapy (Armour
hormone. thyroid)- natural
 Levothyroidine sodium (Levothroid
Synthroid)-synthetic taken first thing in
the morning.

Hyperaldosteronism is an endocrine disorder that involves one Medication

or both of your adrenal glands creating too much of a hormone
called aldosterone. This causes your body to lose too much
potassium and retain too much sodium, which increases water
E.
Hyperaldosteronism retention, blood volume, and blood pressure.
 Primary hyperaldosteronism is caused by a problem
with one or both adrenal glands. It’s sometimes
referred to as Conn’s syndrome. By a benign tumor on
one of the adrenal glands adrenocortical cancer and
other types of inheritable issues that affect the
adrenal glands
 Secondary hyperaldosteronism is caused by
something outside the adrenal glands. It’s usually
related to reduce blood flow to your kidneys. A
blockage or narrowing of the renal artery chronic liver
disease, heart failure and diuretic medications.
 Mineralocorticoid receptor antagonist,
such as spironolactone. This type of
medication blocks the effects of
aldosterone on your body, such as high
blood pressure and low blood
potassium.
Surgery
 Remove the affected gland. Following
the procedure, called an
adrenalectomy, you’ll likely notice a
gradual decrease in blood pressure.
Lifestyle changes
 Eating a healthy diet. A diet lower in salt
is often key in hyperaldosteronism.

F. Diabetes insipidus  Diabetes insipidus can occur as a result of decreased
circulating levels of vasopressin (ADH).
 Deficiency of ADH causing metabolic disorder
characterized by severe polydipsia, and polyuria.
 Kidney failure, nephrogenic diabetes insipidus,
pyelonephritis, chronic renal failure, polycystic disease
and medications such as lithium carbonate
(Carbolith), amphotericin B (Fungizone), furosemide
(Lasix).
G. syndrome of  Often non- endocrine in origin: cancer cells in
inappropriate bronchogenic carcinoma synthesize and release ADH
antidiuretic hormone  CNS disorder: head or brain injury, surgery, tumor,
infection
 Medications Vincristine (Oncovin), mood stabilizer
drugs, anti- epileptic drugs, Thiazide diuretics and
Nicotine.
 Excessive ADH secretion even with subnormal serum
osmolality (osmolality >300 mOsm/kg).
 Strokes, hemorrhages trauma, Tumors, small cell
carcinoma in the lungs, brain surgery.
H. Cushing's disease  Exdogenous medications like steroids
 Endogenous-excessive Acth made in the body
 Small cell lung cancer
 Tumors of adrenal gland
 Excess level of cortisol
I. Addison disease  Decrease secretion of cortisol and aldosterone
 Tuberculosis,histoplasmosis, HIV and meningococcal
pneumonia.
 Bilateral adrenalectomy
 Adrenal gland hemorrhage, Trauma, surgery and
withdrawal of steroids.
J. Pheocromocytoma  The tumor releases hormones that cause either
episodic or persistent high blood pressure.
 Excessive secretion of epinephrine and
norepinephrine.
 Exercising. Consistent exercise, even just
a 30-minute walk a few times a week,
can help to reduce blood pressure.
 Reducing alcohol and caffeine.
 Quitting smoking.
 Desmopressin as a nasal spray, as oral
tablets or by injection. The synthetic
hormone will eliminate the increase in
urination.
 Doctor may prescribe a low-salt diet to
help reduce the amount of urine your
kidneys make.
 Decreasing the amount of fluid intake.
 Undergoing disorder must be treated or
medications stopped that may
contribute to SIADH.
 Water restriction must implemented.
 Serious hyponatremia (>120 mEq/L)
treated with hypertonic IV
administration 0.9% NaCl
 High salt and high protein diet
Medication
 Furosemide (Lasix) ↑urine output.
 Democlocycline hydrochloride
(declamycin) and adrocortisone
(Florinef) enhance sodium retention.
Surgery: Adrenalectomy
Medications
 Aminoglutethimide
 Ketoconazole
 Mitotane
Diet: High in sodium and low in potassium.
Medications
 Glucocorticoids such as hydrocortisone
(Hydrocortone) and mineralocorticoids
such as (FLorinef)
Medications
 Phentolamine mesylate(Regitine or
nitroprusside sodium (Nipride)
  Phentolamine mesylate (regitine) and
Phenoxybenzamine HCI (dibenzyline)
alph- adrenergic blocking agent
 Metyrosine (Demser)
 Alpha blockers
 Beta blockers
 High-salt diet, high in protein with
adequate calories.

Surgery:

 Laparoscopy
 Adrenal gland removal Adrenalectomy
 Tumor removal

Cancer treatments

 Radionuclide treatment. This radiation

therapy combines MIBG, a compound
that attaches to adrenal tumors, with a
type of radioactive iodine.
 Chemotherapy
 Targeted cancer therapies