Primary care is where most diagnoses of pituitary adenoma are made and pituitary adenomas are responsible for almost all pituitary problems. They typically present with a combination of symptoms of space occupation, hypopituitarism and/or inappropriate hormone secretion. As early diagnosis with optimal initial management and expert follow up in the long term help minimize morbidity, it could be argued that once conspicuous features of classical hormone-excess phenotypes such as acromegaly or Cushing’s disease have emerged, diagnosis has been unduly delayed, even though the adenomas themselves are intrinsically benign. It is important that medical practitioners are well informed, take the opportunity to encourage patients to be the same by directing them to ‘The Pituitary Foundation’ web site (http://www.pituitary.org.uk/), and that good rapport with the patient and often with the patient’s immediate family is established at the outset as all parties are ‘in it for the long haul’. Remember that as much as we delight in demonstrating syndromes to trainees, the adverse physical and psychological impact of these troublesome conditions should not be under-estimated. It is also important not to be distracted from the need to address general risk factors such as hypertension, hyperlipidaemia and glucose intolerance which are often enhanced, and to keep in mind that symptoms such as arthritis, headaches and obstructive sleep apnoea should be identified and dealt with as vigorously as they would be in any other patients and in very much the same way.
|Translated title of the contribution||Pituitary problems in primary care|
|Pages (from-to)||793 - 800|
|Number of pages||7|
|Publication status||Published - 2008|