767
he endocrine system, in concert with the nervous sys-
tem, serves to regulate and integrate the functioning
of the body’s many cells and organ systems. Disorders
of the endocrine system can affect many aspects of body
functioning, including growth and development, energy
metabolism, muscle and adipose tissue distribution,
sexual development, fluid and electrolyte balance, and
inflammatory and immune responses.
This chapter focuses on disorders of the anterior
pituitary gland, growth and growth hormone, thyroid
gland, and adrenocortical hormones. Disorders of the
parathyroid hormone are discussed in Chapter 8, insulin
in Chapter 33, and the male and female gonadal hor-
mones in Chapters 39 and 40.
General Aspects of Altered
Endocrine Function
Several processes can disturb the normal function of the
endocrine system, including impaired or uncontrolled
synthesis or release of hormones, altered interactions
between hormones and their target tissues, or abnor-
mal responses of the target tissues to their hormones.
Diseases involving the endocrine system most com-
monly present with signs of hypofunction or hyperfunc-
tion.
1
The disorder can occur as a primary disorder of an
endocrine organ or as a secondary or tertiary disorder
involving hormones produced by the pituitary gland or
hypothalamus.
Hypofunction and Hyperfunction
Hypofunction
of an endocrine gland can occur for
a variety of reasons. Congenital defects can result in
the absence or impaired development of an endocrine
T
Disorders of
Endocrine
Control of
Growth and
Metabolism
32
C h a p t e r
General Aspects of Altered Endocrine Function
Hypofunction and Hyperfunction
Primary, Secondary, and Tertiary Disorders
Anterior Pituitary and Growth Hormone Disorders
Control of Anterior Pituitary Function
Clinical Manifestations of Hypothalamic-
Pituitary Disorders
Assessment of Hypothalamic-Pituitary Function
Pituitary Adenomas and Hyperpituitarism
Hypopituitarism
Growth and Growth Hormone Disorders
Growth Hormone
Short Stature in Children
Growth Hormone Deficiency in Adults
Tall Stature and Growth Hormone Excess in
Children
Growth Hormone Excess in Adults
Precocious Puberty
Thyroid Hormone Disorders
Structure and Function of the Thyroid Gland
Synthesis of Thyroid Hormones
Regulation of Thyroid Hormone Secretion
Actions of Thyroid Hormone
Tests of Thyroid Function
Thyroid Disorders
Hypothyroidism
Hyperthyroidism
Adrenal Cortical Hormone Disorders
Adrenal Cortical Hormones
Mineralocorticoid Hormones
Glucocorticoid Hormones
Adrenal Androgen Hormones
Pharmacologic Suppression of Adrenal Function
Tests of Adrenal Function
Adrenal Cortical Disorders
Congenital Adrenal Hyperplasia
Adrenal Cortical Insufficiency
Glucocorticoid Hormone Excess
Incidental Adrenal Mass
