Symmonds syndrome is a progressive depletion. With this disease, people develop signs of hypocorticism. That is, hypotension is observed along with adynamia, anorexia, hypothyroidism, dry skin, chilliness, senile appearance, mental retardation and decreased sexual desire.
In addition, in such patients, hair loss is noted. Including in the axillary and pubic region. At a young age, in the presence of this syndrome, the growth and process of ossification slows down. Eating disorder leads to vitamin deficiency and anemia.
Body depletion
Such patients are unstable to infections, in addition, in stressful situations they very easily fall into a hypopituitary coma as a result of an acute deficiency of the functions of the adrenal cortex.
The most striking sign of Simmon's Syndrome syndrome is the absolute exhaustion of the body. In this regard, another name for this disease is the medical term "pituitary cachexia." The causes, symptoms, diagnosis and treatment of this pathology will be further discussed in our article.
What is the mechanism for the development of Shien Simmonds syndrome?
A bit of history
For the first time, this disease, which is also called pituitary cachexia in medicine, was described by Glinsky in 1913. And only one year later, this syndrome was described by the scientist S. Simmonds. Since then, this pathology was subsequently called by his name.
It is worth noting that until that time, the disease was considered a manifestation of other ailments. He was recognized as a cardinal exhaustion syndrome against tuberculosis, diabetes mellitus, progressive paralysis and malignant tumors. Simmonds proved that pituitary cachexia appears as a result of pituitary dystrophy and due to the cessation of hormone production.
A little later, in the late seventies, the scientist Skien described the symptoms of pituitary cachexia in the fairer sex after a difficult birth. He found that such extreme weight loss, along with the disappearance of all sexual characteristics and very white skin, is directly associated with pituitary dystrophy due to massive blood loss, cerebral hemorrhage, postpartum inflammatory process and sepsis.
Hormone deficiency
The cause of Simmonds syndrome is hypopituitarism, that is, a deficiency of tropic hormones that are produced by the pituitary gland. Often this disease manifests itself in a very massive way, covering the work of the whole organism as a whole, but in the first place there are signs of a hormonal disorder associated with the absence of certain hormones.
The identification of this syndrome is determined in violation of the synthesis of seventy percent of the hormones. As a rule, this stops the production of hormones in the anterior pituitary gland.
How is the situation normal? Hormones through the blood penetrate into various glands. For example, in the adrenal glands, testicles, ovaries and thyroid gland. Pituitary dysfunction provokes a malfunction of hormonal production. The result is a malfunction of various organs and systems. For example, a lack of prolactin provokes agalactia - the absence of milk in lactating women.
Weight loss
Inadequate production of hormones by the adrenal glands contributes to digestive upset and weight loss. Against this background, nausea, vomiting, and a decrease in the secretion of the stomach and intestines can occur, which leads to sharp weight loss.
This symptomatology should be differentiated with anorexia nervosa. The fact is that with anorexia, too, sharp weight loss is often observed.
The first signs of this syndrome are a loss of interest in life after pregnancy and childbirth, the appearance of apathy, constant fatigue, and, in addition, amnesia and drowsiness. Hallucinations are also possible. All this is observed against the background of rapid weight loss and hair loss.
A small amount of thyroid hormones in the body causes chilliness, along with memory and speech disorders. Apathy and disturbance in the work of the cardiac and vascular system are also possible.
So, then we find out what factors are the main reasons for the development of Simmonds Sheehan syndrome.
Causes of the syndrome
Reducing the amount of sex hormones causes sexual dysfunction and osteoporosis. Among other things, such patients may also experience severe headaches and ophthalmic disorders.
The main causes of Simmonds syndrome and the cessation of hormone production (and in severe cases, the body stops producing 90% of the hormones) are:
- The appearance of a pituitary tumor.
- The development of autoimmune pituitary gland.
- The presence of birth defects in the development of the Turkish saddle.
- Conducting radiation therapy.
- Various surgical interventions.
- The effect of infectious and vascular diseases, for example, with syphilis or tuberculosis.
- The presence of genetic pathologies in the patient, for example, Kallman syndrome.
- The result of massive blood loss. The reasons may include postpartum, septic, surgical, gastric, cerebral hemorrhage and the like.
Now we will understand how this disease manifests itself, and what symptoms it accompanies.
Clinical symptoms
Most often, Simmonds syndrome affects women who are of childbearing age. Thus, most often they suffer from women aged twenty to forty years.
Men are extremely susceptible to this disease. True, cases of the development of panhypopituitarism among older women have been described in medical practice. In addition, an atypical example was recorded in a teenage girl with juvenile bleeding.
Symptoms of Symmonds syndrome should not go unnoticed.
Pathology develops in cases where the hormone deficiency reaches 70%. As a rule, the symptomatology of the manifestation of this pathology directly depends on which hormones are absent, but there are also a number of characteristic common signs, namely:
- Weight loss. Against this background, a person loses the total mass, the volume of muscle tissue is lost, all internal organs are proportionally reduced. Weight loss can range from two to twelve kilograms per week.
- The appearance of dryness, wrinkling and depigmentation of the skin. It becomes more wrinkled, gradually thinning. The skin, against the background of this syndrome, acquire a waxy color, becoming very white.
- Fragility of nails occurs, teeth begin to decay.
- Fragility of the hair is observed, along with their bleaching, hair loss and gray hair. Thus, premature aging of the body occurs.
- Additionally, there is a lack of hair in the armpits and on the pubis.
- In a sick person with this syndrome, the voice becomes quiet and deaf.
- Among other things, there is constant drowsiness, along with lethargy, complete emotional apathy, cretinism, amnesia and the appearance of hallucinations is not ruled out.
Secondary symptoms
The role of secondary signs is a decrease in the internal, and at the same time external genitals, the mammary glands become smaller, there is no milk in lactating women, there are scanty menstruation during the cycle, which, after childbirth, as a rule, does not resume. In addition, in such patients there is an absolute absence of sexual desire.
How to identify Simmonds syndrome?
Diagnosis of the syndrome
It is possible to suspect the development of an ailment according to the anamnesis and objective symptoms that are detected during examination. But establishing an accurate diagnosis of Simmonds syndrome requires additional measures:
- One of the main diagnostic methods, which is very informative today, and therefore popular, is the conduct of magnetic resonance imaging. In addition to it, as part of the examination of a patient with suspected syndrome, radiography is performed along with computed tomography and echoencephalography.
- Additionally, doctors can prescribe a number of tests, and, in addition, various tests to determine the hormonal status of the patient.
- According to the standard scheme, clinical tests of urine and blood are not complete, allowing to evaluate the general health of the whole organism.
Next, we will understand how the treatment of Simmonds syndrome is carried out.
Syndrome treatment
Therapy of such a serious deviation as pituitary cachexia, first of all, involves the elimination of the causes of the disease. This may be the treatment of infections, removal of the tumor, and the like.
Without fail, such patients are prescribed concurrent treatment with synthetic hormones and corticosteroids. In this case, doctors first treat secondary hypocorticism.
Women suffering from this syndrome are prescribed primarily hormones such as estrogen and progestin, while it is advisable for men to undergo a therapeutic course with androgens. Then they go on to taking thyrotropin, and only after the hormonal background is completely normalized, thyroid hormones are prescribed to patients.
As a rule, in addition to patients, growth hormone is prescribed, but as for mineralocorticoid drugs, those are not required. Hypopituitary coma is treated in the same way as with adrenal insufficiency.
Disease prognosis
The prognosis for this disease directly depends on the level of damage to the hypothalamus and pituitary gland, as well as on the degree of substitution treatment possibilities.
An absolute recovery for such patients, unfortunately, is impossible, but, as a rule, the prognosis is quite favorable for life and work.
It is worth noting that a disease such as Simmonds syndrome is extremely difficult to treat, and hormone replacement therapy is far from always effective.