The child was diagnosed with gigantism due to hypersecretion of growth hormone from the pituitary gland. The pituitary gland, located at the base of the skull, regulates many other endocrine glands through releasing and inhibitory hormones. Gigantism results from excess growth hormone secretion before epiphyseal plate closure, leading to abnormally large limbs, jaw, hands and feet. Growth hormone increases protein synthesis, fat mobilization and glucose conservation, and its long-term hypersecretion can cause diabetes by overstimulating the pancreas.
2. Question:
A child XYZ presented in nutrition ward with age of 10 years, medical
nutritionist notices that he is larger than other children of same age. He
notices also some parts of his body larger in proportion to other parts
with symptoms of larger hands and feet, big toes and fingers, prominent
jaw and forehead with coarse physical features.
a) What is the diagnosis ?
Child is diagnosed with Gigantism
3. Pathophysiology:
• It is a pituitary disorder characterized by excess growth of body due
to hypersecretion of growth hormone in the body .
• Hypersecretion can be in preadult life or childhood before the fusion
of epiphysis of bone with shaft
4.
5. Pituitary gland :
• Hypophysis is a small endocrine gland
present in the sphenoid bone at the base
of skull.
• It is connected with hypothalamus by the
pituitary stalk or hypophyseal stalk
6.
7. Divisions of pituitary gland:
1.Anterior pituitary or adenohypophysis
2.Posterior pituitary or neurohypophysis
8. Anterior pituitary:
• It is also known as master gland because it regulates many other
endocrine glands
• Hypothalamus control the secretions by secreting releasing and
inhibitory hormones which are called as NEUROHORMONES
10. Regulation of Hormones secreted by anterior pituitary:
Neurohormones released from hypothalamus is transmitted to anterior
pituitary by hypothalmo-hypophyseal portal system
Hormones secreted from anterior pituitary:
Six hormones are secreted from anterior pituitary
and first five are known as tropic hormones
11. Their names are listed below:
1. Growth hormone or somatotropic
hormone
2.Thyroid stimulating hormone
3.Adrenocorticotropic hormone
4.Follicle stimulating hormone
5. Leuteinizing hormone
6.Prolactin
12. Growth hormone:
• It is generally responsible for growth of body
• It increases the size and number of cells by mitotic division
• It also differentiate certain types of cells like bone and muscle cell.
METABOLISM:
• It increases the protein synthesis.
• It mobilizes fat from adipose tissue.
13. ON CARBOHYDRATE METABOLISM
Major function is the conservation of glucose.
DIABETOGENIC EFFECT OF GH:
Hypersecretion of GH increases blood glucose level that causes
continuous stimulation of the β-cells in the pancreas and this
increases secretion of insulin. Due to this excess stimulation β-cells
burn out at one stage. This causes deficiency of insulin leading to
true diabetes mellitusand this effect is known as diabetogenic effect.
