Download Endocrine System Disorders

CHAPTER 12
ENDOCRINE SYSTEM
DISORDERS
BY
Dr.Uche Amaefuna-Obasi (MD)
•THERE ARE MORE
TO LECTURES
THAN JUST POWER
POINT SLIDES 

ENDOCRINE SYSTEM
• System of ductless glands
• Regulates body functions via
hormones secreted into the
bloodstream.
Human Endocrine
Glands
Ductless glands transport
hormones in the blood
Duct glands are exocrine
glands that use tubes to
carry the secretion
(salivary, tears)
2003-2004
ENDOCRINE SYSTEM
Major Endocrine Glands:
• Hypothalamus
• Pituitary Gland
•Thyroid Glan
• Parathyroid Gland
•Thymus
•Adrenal Gland
ENDOCRINE SYSTEM
Other organs containing
endocrine tissue:
• Pancreas
•Kidneys
•Heart
•Digestive Tract
•Placenta
•Testes
•Ovaries
•Pineal Gland
HYPOTHALAMUS
• ‘Master Gland’
• Function : Control centre
• Attached to roof of third ventricle,
near thalamus
• Continuously receive information on
status of body systems via nerve
impulses
• Monitors composition & temperature
of blood
• Messages interpreted, evaluated :
outgoing messages dispatched via
nerves / hormones
• Plays role in feedback systems that
govern secretions of endocrine system
2. PITUITARY GLAND
Pea sized mass of glandular tissue
• Lies in sella turcica
• Slender stalk: Infundibulum
connects pituitary gland to
hypothalamus
• 2 parts : Neurohypophysis
Adenohypophysis
Indirectly controls : Growth
• Metabolism
• Sexual reproduction
• Lactation
2. PITUITARY GLAND: PARTS
Neurohypophysis
Adenohypophysis
Small posterior lobe
Large anterior lobe
Stores hormones
Releases hormones
Oxytocin
Growth hormone (GH)
Anti Diuretic hormone
(ADH)
Thyroid Stimulating hormone
(TSH)
Adenocorticotropic hormone
(ACTH)
Lutenizing hormone (LH)
Follicle stimulating hormone
(FSH)
Melanocyte stimulating
hormone (MSH)
Prolactin (PRL)
2. PITUITARY GLAND: HORMONES
Posterior
Pituitary
Anterior
Pituitary
HORMONES
EFFECTS
Oxytocin (OC)
Stimulates contraction of uterus & contractile
cells of breast
ADH
Prevents excess urine production
GH
General body growth
ACTH
Stimulate adrenal cortex to release hormone
TSH
Controls thyroid gland
LH
Stimulates sexual & reproductive function
FSH
Stimulate production of sperm & egg in
ovaries & testis
MSH
Related to skin pigmentation
PRL
Initiates milk production in breast
Pituitary gland and Hypothalamus serve to link the nervous system
other glands and metabolic functions.
2003-2004
Mechanisms of
hormone
release
(a) Humoral: in response to changing levels
of ions or nutrients in the blood
(b) Neural: stimulation by nerves
(c) Hormonal: stimulation received from other
hormones
12
Learn the 3 endocrine organs on this slide:
Hypothalamus
Pituitary (hyophysis)
Pineal
Hypothalamus__
Anterior pituitary__
(adenohypophysis)
_____________Posterior pituitary
(neurohypophysis)
Hypothalamus___________
Pituitary_________
_
(hypophysis)
13
2003-2004
2003-2004
Endocrine system - together with the nervous system, acts as
the body´s communication network
- it is composed of various endocrine
glands and endocrine cells
- the glands are capable of synthetizing and
releasing special chemical mesengers - hormones
Hormones - substances which are secreted by specialised cells in
very low concentrations and they are able to influence
secreted cell itself (autocrine influence), adjacent cells
(paracrine influence) or remote cells (hormonal influence)
Role of endocrine system in vital
activity of the organism
• The endocrine system is the most important regulatory
system. It carries out regulatory influence by means of
hormones practically on all functions of an organism –
metabolism , growth, reproduction, mental activity,
adaptation, functional activity of all organs.
• Hormones can be synthesized: а) by epithelial cells
(one’s own glandular epithelium ); b) by neuroendocrine
cells (hypothalamic cells); c) by myoendocrine cells
(muscular fibres of heart atriums).
HORMONES
• The word hormone is derived from the Greek
“hormao” meaning “I excite or arouse”
• Hormones communicate this effect by their unique
chemical structures recognized by specific
receptors on their target cells, by their patterns of
secretion and their concentrations in the general or
localized circulation
The main groups of hormones
Classic hormones (produced by specialised glands) are divided into
three groups:
1. low molecular (amine) hormones (catecholamines, thyroid hormones,
prostaglandins, leucotrienes, dopamine, serotonine, GABA,
melatonin ...)
2. steroid hormones (e.g.gluco- and mineralocorticoids)
3. polypeptidic and protein hormones (e.g. insulin, leptin...)
Structure and Function
• Primary function of the endocrine system
– To produce hormones that monitor and coordinate
body activities
• Endocrine glands secrete hormones directly
into the bloodstream
• Three hormone categories
– Tropic hormones
– Sex hormones
– Anabolic hormones
Glands and their Hormones
• Hypothalamus
– Structure located above the pituitary gland that
translates nervous system impulses into endocrine
system messages
• Pituitary gland
– Produces the hormones that regulate the secretion
of other glands
• Pineal body
– Produces the hormone melatonin
Glands and their Hormones
(continued)
• Thyroid
– Produces hormones that regulate body
metabolism
• Parathyroid
– Secretes parathyroid hormone, which affects the
amount of calcium in the blood
• Thymus
– Produces the hormone thymosin that stimulates
the lymphoid organs to produce T-lymphocytes or
antibodies in newborns and young children
3. THYROID GLAND
• Located in middle anterior part of
neck: below larynx, in front of
trachea
• “Butterfly” shape
• 2 lobes connected by isthmus
• ↑ in size : puberty & pregnancy
• Rich blood supply: able to deliver
high levels of hormones in short
period of time
• Produces Thyroxin (T4) & Triiodothyronine (T3)
• Calcitonin : involved in calcium &
phosphate homeostasis
4. PARATHYROID GLAND
• Small rounded mass
• Attached to posterior
surface of thyroid gland
• Produces Parathyroid
hormone (PTH)
• Controls homeostasis of
calcium & phosphate in
blood by activating Vitamin
D
Thyroid and Parathyroid help regulate calcium metabolism
Feedback!
5. THYMUS
•Plays a role in the immune
system
•Produces thymosin,
thymic humaral factor &
thymic factor
•Responsible for
maturation of Tlymphocytes
HARMONES OF THYROID, PARATHYROID & THYMUS
ORGAN
HORMONE EFFECT
Thyroid gland
T3 & T4
(Follicular cells)
energy utilization
oxygen consumption
growth & development

Thyroid gland
(C cells)
Calcitonin
 Calcium ion concentration
in body fluids
Parathyroid
PTH
 Calcium ion concentration
in body fluids
Thymus
Thymosin
Maturation & functional
competence of immune
system
Glands and Their Hormones
(continued)
• Pancreas
– Produces the hormones insulin and glucagon.
Insulin regulates transportation of sugar, fatty
acids, and amino acids into the cells.
• Adrenal glands
– Produce about 30 hormones
• Gonads
– The primary sex glands
6. ADRENAL GLAND
• Located superior to the
kidney
• Divided into:
• (i) outer cortex
(ii) inner medulla
6. ADRENAL GLAND
ADRENAL CORTEX
ADRENAL MEDULLA
Secretes steroid hormones
Secretes hormones controlled by
ANS
Glucocorticoids (metabolism) eg.
cortisol
Epinephrine (Adrenaline)
Mineralocorticoids (homeostasis of Norepinephrine (Noradrenaline)
ions) eg. Aldosterone
Gonadocorticoids (oestrogens &
androgens)
ADRENAL HORMONES
REGION
Cortex
1. Zona
glomerulos
2. Zona
fasciculata
3. Zona
Reticularis
Medulla
HARMONES
Mineralocortic
oid:
Aldosterone
Glucocorticoid:
cortisol
EFFECT
Renal reabsorption of
sodium ions & water.
renal potassium ion loss
Releases amino acids from
skeletal muscle & lipids from
adipose.
Promotes liver glycogen &
glucose formation
Androgens
Anti inflammatory effect
Epinephrine
cardiac activity
(Adrenaline),
blood pressure
Norepinephrine glycogen breakdown
(Noradrenaline)
blood glucose
7. PANCREAS
• Flattened organ
• Lies retroperitoneally &
transversly across posterior
abdominal wall
• Posterior to stomach, between
doudenum on right & spleen on left
• Classified as exocrine &
endocrine Hormones:
• Islets of Langerhans secrete:
Glucagon,  cells :  blood glucose
Insulin,  cells:  blood glucose
• Growth harmone inhibiting
hormone (GHIH),  cells : inhibits
glucagon & insulin
HORMONES OF PANCREAS
CELLS
HARMONE EFFECT
Alpha () cells
Glucagon
Glucose synthesis & glycogen
breakdown in liver
 Blood glucose concentration
Beta () cells
Insulin
Stimulation of lipids & glycogen
storage & formation
 Blood glucose concentration
Delta () cells
Somatostatin
Inhibits secretion of insulin &
glucagon
12 & 13. TESTES & OVARIES
TESTES:
• Located within scrotum
• Produce testosterone
• Stimulates development of male
sexual characteristics
OVARIES:
• Located in pelvic cavity
• Produce oestrogen &
progesterone
• Responsible for development &
maintenance of female
characteristics & menstrual cycle
HORMONES OF REPRODUCTIVE SYSTEM
CELLS
HORMONES
EFFECT
Testes
Interstitial cells
1. Testosterone
2. Inhibin
1. Maturation of sperm
Male secondary sex characteristics
2. Inhibits secretion of FSH
Ovaries
Follicle cells
1. Oestrogen
2. Inhibin
1. Follicle maturation
Female secondary sex characteristic
2. Inhibits secretion of FSH
Corpus Luteum
Progesterone
Prepare uterus for implantation
Prepare breast for secretory function
OTHER ENDOCRINE TISSUES
KIDNEYS:
• Renal Erythropoietic factor: erythropoietin
HEART:
• Atrial Natriuretic factor (ANF)
GIT:
• Stomach gastrin, enteric gastrin, secretin, cholecystokinin,
enterocinin, gastric inhibiting hormone
PLACENTA:
• Human chorionic gonadotropin, oestrogen, progesterone, relaxin
Glands and Their Hormones
(continued)
• Prostaglandins
– Known to decrease blood pressure, cause fever,
increase hydrochloric acid secretion in the
stomach, increase uterine contraction during
pregnancy, and influence intestinal peristalsis
PROSTAGLANDINS
• Regulators of cell metabolism
Important in normal physiology of:
Pathology: Induce
Inflammation
• Smooth muscle
• Promote fever
• Blood flow
• Intensify pain
• Platelet function
• Nerve transmission
• Immune response
• Secretion
• Reproduction
• Respiration
• Fat Metabolism
FEEDBACK CONTROL OF HORMONE RELEASE
• Regulation
Eg. Production of releasing substance / inhibiting substance
 Release of hormone from pituitary gland
 stimulates hormone release by target gland
 hormone exert normal effect & influence further release
of a releasing or inhibiting substance
 inhibit release of hormone from pituitary gland
STARTER answers
Pituitary gland – FSH, LH (stimulates the release and maturity of
follicles during menstruation)
Thyroid gland – Thyroxine (regulates the rate of metabolism)
Adrenal gland - corticosteroids and catecholamines including
cortisol and adrenaline and small amounts of testosterone
(regulates stress levels)
Pancreas – peptides (regulates the production of shorter active
digestive enzymes)
Ovary – oestrogen, progesterone and small amounts of
testosterone (regulates the growth of eggs and stabilises the
growing foetus during pregnancy)
Testis – testosterone (plays a key role in the health and well-being
of the man)
Hormonal Changes of Puberty
• Adrenal gland secretes the hormones that
begin the development of secondary sexual
characteristics
• In a man, the voice deepens and facial hair
begins to grow
• In a woman, the breasts enlarge and fatty
tissue is deposited around the hips
• In both men and women height and weight
increase
Hormonal Changes of Pregnancy
• The placenta, or interfacing organ between the fetal
and maternal circulation, produces a hormone called
human chorionic gonadotropin (hCG)
• Increased estrogen and progesterone from the
ovaries are maintained until the placenta begins to
produce these hormones
• Progesterone increases the mobility of the pelvic and
lower back bones to allow the birthing process
• The pituitary and thyroid glands increase in size,
resulting in a higher metabolic rate
Hormonal Changes of Menopause
• Menopause occurs following a decrease in
secretion of the gonadotropins folliclestimulating hormone (FSH) and luteinizing
hormone (LH)
• A decrease in the secretion of the hormone
estrogen by the ovaries occurs
• Hot flashes, periods of feeling extreme heat,
are the only universal symptom of
menopause
Assessment Techniques
•
•
•
•
•
Basal metabolic rate (BMR)
Protein-bound iodine (PBI)
Immunoassay
Radioiodine uptake (RAIU) studies
Glucose tolerance testing (GTT)
CHALLENGES WITH THE
ENDOCRINE SYSTEM
• Too much or too little of any hormone can be harmful to the body
• If the pituitary gland produces too much growth hormone, a child
may grow excessively tall
• If it produces too little, a child may be abnormally short
Etiology of endocrine disorders
Reasons of disorders:
mental trauma, necrosis, tumor, inflamatory
process, bacterial and viral infections,
intoxications, local disorders of blood circulation
(hemorrhage, thrombosis), alimentary disorders
(deficiency of iodine and cobalt in food and
drinking water, redundant consumption of
carbohydrates), ionising radiation, inherent
chromosome and gene defects.
Types of endocrine disorders
• 1. Hyperfunction of endocrine glands
• 2. Hypofunction of endocrine glands
• 3. Dysfunction of endocrine glands
Endocrine disorders can result from dysfunction
originating in the peripheral endocrine gland
itself (primary disorders) or from under
stimulation or overstimulation by the pituitary
(secondary disorders). The disorders can result in
hormone overproduction (hyperfunction) or
underproduction (hypofunction)..
Pathogenesis of endocrine disorders
• 1. Disorders of endocrine glands
regulation – deregulatory disorders;
• 2. Disorders of hormones biosynthesis and
their secretion – glandular disorders;
• 3. Disorders of the transport, reception and
metabolism of hormones – peripheral
disorders.
THYROIDAL DYSFUNCTION
AND ENVIRONMENTAL
CHEMICALS
Thyroid hormones are essential for normal brain
development during a critical period beginning
in utero and extending through the first 2 years
postpartum
Thyroid Gland
Hormone: Thyroxin
Overactivity (Too much hormone)
- Increased metabolic rate
- Increased food intake but loss of weight
- Hyperthyroidism (Grave’s disease)
- Goitre (swollen neck, maybe bulging eyes)
Goitre
Thyroid Gland
Hormone: Thyroxin
Underactivity (Not enough hormone)
-
Hypothyroidism (Hashimoto’s disease)
Reduced metabolic rate
Low food intake but gain of weight
Myxoedema (when onset in adults)
Cretinism (when onset in children)
Can also cause a goitre
Myxoedema
•
•
•
•
•
•
Puffiness (swelling)
Fatigue
Obesity
Dry, thickened skin
Mental impairment
Thin, brittle hair
Cretinism
•
•
•
•
Protuberant abdomen
Short Stature
Infertility
Neurological
impairment
• Constant Fatigue
• Obesity
ENDEMIC CRETINISM ENVIRONMENTAL
DISEASE
Children with endemic cretinism suffer from hypothyroidism that
begins at conception because the dietary iodine deficiency prevents
synthesis of normal levels of thyroid hormones
Symptoms include :
•
Mental retardation that can be profound
•
Spastic diplegia: historically known as Little's Disease, is a form of
cerebral palsy (CP) that is a chronic neuromuscular condition of
hypertonia and spasticity manifested as an especially high &
constant "tightness" or "stiffness" in the muscles of the lower
extremities of the human body, usually those of the legs, hips &
pelvis.
•
Problems with gross and fine motor control resulting from damage to both
the pyramidal and the extrapyramidal systems
Thyroid Gland
Hormone: Calcitonin
Overactivity
- Increased Bone Ca, decreased Blood Ca
- Tetany (nerve problems leading to muscle spasms or
cramps)
Underactivity
- Increase Blood Ca, decreased Bone Ca
- Osteoporosis (brittle bones)
- Kidney stones
HYPERTHYROIDISM
• Hyperthyroidism is a condition in which the levels of thyroid
hormones in the blood are excessively high
• Symptoms may include:
weight loss, nervousness, tremors, excessive sweating,
increased heart rate and blood pressure, protruding eyes, and a
swelling in the neck from an enlarged thyroid gland (goiter)
HYPOTHYROIDISM
• Hypothyroidism is a condition in which levels of thyroid
hormones in the blood are abnormally low. Thyroid hormone
deficiency slows body processes
• Symptoms may include fatigue, slow heart rate, dry skin
• In children: slower growth and delayed puberty
• Hashimoto's thyroiditis, which results from an autoimmune
process that damages the thyroid and blocks thyroid hormone
production, is the most common cause of hypothyroidism in kids
Parathyroid Glands
Hormone: Parathormone (PTH)
Underactivity
- Low Blood calcium, High Bone Ca
- Tetany
Overactivity
- High Blood calcium, Low Bone Ca
- Osteoporosis
Calcitonin Vs. Parathormone
Calcitonin –
Over Reactivity
Under Reactivity
Blood Ca
Parathormone -
Blood Ca
Tetany
Blood Ca
•Osteoporosis
•Kidney Stones
Blood Ca
•Osteoporosis
•Kidney Stones
Blood Ca
Tetany
Blood
Ca
Pancreas
Hormone: Insulin
Overactivity
- Low blood sugar level ( ↓BSL)
- Hypoglycemia
Underactivity
- High blood sugar level ( ↑BSL)
- Hyperglycemia
- Diabetes
Pancreas
Hormone: Glucagon
Overactivity
- High blood sugar level ( ↑BSL)
- Diabetes
Underactivity
- Low blood sugar level ( ↓BSL)
- Hyper insulinism
Insulin vs Glucagon
Insulin –
Over Reactivity
Under Reactivity
BSL
BSL
Hypoglycemia
BSL
•Hyperglycemia
•Diabetes
Glucagon -
BSL
BSL
•Hyperglycemia
•Diabetes
BSL
Hypoglycemia
Anterior Pituitary Gland
Hormone: Growth Hormone
Overactive
- Gigantism (children - very tall)
- Acromegaly (adults - bones & skin thicken)
Underactive
- Dwarfism (very short)
Gigantism
The man holding
the baby in the
photo is 8 ft, 2.5
inches tall
Acromegaly
Dwarfism
Dwarfism occurs
when there is short
supply of GH in
childhood. There are
two types of
dwarfism – Lorrain
and Frohlich’s
Disorders of the Endocrine
System
• Acromegaly
– An enlargement of the bones of the hands, feet,
and jaws
• Addison's disease
– Caused by hyposecretion of the hormones
produced by the cortex of the adrenal gland
• Cretinism
– Condition resulting from a congenital deficiency of
thyroid secretion or hypothyroidism
Disorders of the Endocrine System
(continued)
• Cushing’s syndrome
– Disorder that causes hyperactivity of the adrenal
glands, which is triggered by the oversecretion of
the pituitary hormone ACTH
• Diabetes insipidus
– From an acquired or inherited decrease in the
antidiuretic hormone secreted by the pituitary
• Diabetes mellitus
– A disorder of carbohydrate, fat, and protein
metabolism resulting from insufficient insulin
production by the pancreas
DIABETES
• Group of diseases marked by high levels of blood glucose
resulting from defects in insulin production, insulin action, or
both
• Diabetes can lead to serious complications and premature
death
• More than 220 million people worldwide have diabetes
• More than 80% of diabetes deaths occur in low- and middleincome countries
TYPE 1 DIABETES
• Previously called insulin-dependent diabetes mellitus (IDDM)
or juvenile-onset diabetes
• Type 1 diabetes develops when the body's immune system
destroys pancreatic beta cells. This form of diabetes usually
affects children and young adults
• Risk factors for type 1 diabetes may be autoimmune, genetic
or environmental
CHEMICALS AND TYPE 1
DIABETES
•
Chemicals or drugs can be environmental triggers to diabetes
•
Some that have been considered include:
–
–
–
•
the chemical Alloxan
the rodenticide Vacor
and the drugs Streptozotocin and Pentamidine
All of these may cause an immune system response that could
result in the destruction of insulin-producing cells
TYPE 2 DIABETES
•
Previously called non–insulin-dependent diabetes mellitus (NIDDM) or
adult onset diabetes
•
Type 2 diabetes comprises 90% of people with diabetes around the world,
and is largely the result of excess body weight and physical inactivity.
•
Symptoms may be similar to those of Type 1 diabetes, but are often less
marked. As a result, the disease may be diagnosed several years after
onset, once complications have already arisen.
•
Until recently, this type of diabetes was seen only in adults but it is now
also occurring in children
Rising prevalence of this type of diabetes in children has
paralleled the dramatically increasing rates of obesity among
children
Disorders of the Endocrine System
(continued)
• Dwarfism
– Results from hyposecretion of the growth
hormone of the pituitary gland, which has been
caused by a tumor, infection, genetic factors, or
trauma
• Gigantism
– An excessive growth of the long bones caused by
hypersecretion of the somatotropic hormone
• Graves’ disease
– Caused by hyperthyroidism or thyrotoxicosis
Disorders of the Endocrine System
(continued)
• Hyperparathyroidism
– Causes hypercalcemia, an increased calcium blood
level
• Hypoglycemia
– Results from increased insulin production by the
pancreas
• Hypoparathyroidism
– A decreased secretion of parathyroid hormone
that causes tetany
Disorders of the Endocrine System
(continued)
• Hypothyroidism
– Also called Hashimoto's disease, results from an
insufficient production of thyroxine
• Syndrome of inappropriate antidiuretic hormone
(SIAD)
– Involves water intoxication and the dilution of
intracellular and extracellular body tissues, usually
resulting from lung cancer
• Virilism
– Results from increased secretion in the adrenal glands
THE EPIDEMIC OF OBESITY IN
CHILDREN AND ADOLESCENTS
• Prevalence of obesity has reached
alarming levels
• It affects both industrialized and
developing countries of all socioeconomic groups, irrespective of age,
sex or ethnicity
WHO
Nearly 43 million children under the age of five were
overweight in 2010 (WHO)
OBESITY: CONTRIBUTING FACTORS
• Genetic
• Behavioural
• Environment
Home, child care, school and
community environments can
influence children's behaviors
related to food intake and physical
activity
WHO
WHY IS CHILDHOOD OBESITY
CONSIDERED A HEALTH PROBLEM?
• Heart disease, caused by:
– high cholesterol and/or
– high blood pressure
• Type 2 diabetes
• Asthma
• Sleep apnea
• Social discrimination
PREVENTION: HOW TO MAINTAIN A
HEALTHY WEIGHT ?
Policy and environmental change initiatives that make
healthy choices in nutrition and physical activity
available, affordable, and easy will likely prove most
effective in combating obesity
Balancing calories
 Help children develop healthy eating habits
 Help children eat organic food
 Help children stay active and reduce sedentary time
Issues and Innovations
• Steroid abuse
– Causes problems for men such as stunted
growth, liver tumors, and decreased sperm
production
– Causes problems for women such as loss of
menstrual cycle and baldness
PRECOCIOUS PUBERTY
•
Puberty is the process of physical maturation manifested by an
increase in growth rate and the appearance of secondary sexual
characteristics
•
Precocious puberty has most commonly been defined as the onset
of puberty (appearance of any sign of secondary sexual
maturation) before the age of 8 yr in girls and before the age of 9
yr in boys.
•
It involves early physical changes of puberty & also linear growth
acceleration and acceleration of bone maturation, which leads to
early epiphyseal fusion and short adult height.
PRECOCIOUS PUBERTY & ENVIRONMENTAL
EXPOSURES
Mycotoxins - mycoestrogen Zearalenone produced by the fungus
Fusarium spp. suspected to be a triggering factor for precocious
puberty development in girls
• DDT (dichloro diphenyl trichloroethane), DDE (Dichlorodiphenyl
dichloroethylene), PCBs (polybrominated bipheny), and
phthalates have been associated with early puberty
•
Drug exposure: compounds with estrogenic activity may be
present in some drugs like oral contraceptives
HYPOSPADIAS
One of the most common birth defects
Incidence: 1 in 250 newborn males; the number
has doubled in the last 3 decades
(Paulozzi,1997)
Etiology: remains unknown but there is a
correlation with maternal environmental
exposure and endocrine disruptors
Hypospadias can be defined as an anatomical defect
in the formation of the urethra on the ventral aspect of
the penis, an arrest in the development of the normal
circumferential prepuce, and varying degrees of
penile curvature.
A working hypothesis to explain the etiology of
hypospadias as well as the increase in hypospadias is
maternal environmental exposure or endocrine
disruptors.
MATERNAL & PATERNAL RISK
FACTORS FOR CRYPTORCHIDISM
AND HYPOSPADIAS
•
•
•
•
Paternal pesticide exposure - cryptorchidism
Paternal smoking - hypospadias
Small gestational age - hypospadias
Preterm birth - cryptorchidism
DIETHYLSTILBESTROL (DES)
AND CRYPTORCHIDISM
• Prenatal exposure to DES (Diethylstilbestrol), a
synthetic estrogen, increases risk of male urogenital
abnormalities and the association is strongest for
exposure that occurs early in gestation
• Study findings support the hypothesis that endocrine
disrupting chemicals may be a cause of the increased
prevalence of cryptorchidism that has been seen in
recent years
MSH - Melanocyte Stimulating Hormone – causes
color cells (melanocytes) in skin to darken
Overactive
• Skin darkens
Under active
• Skin will not darken
• Most severe condition is
albinism
LH, FSH, ICTH – sex hormones in males
and females that aid in sperm or egg
(gamete) production
Overactive
• Unknown
Underactive
• Sterility
Corticoids – inc. blood pressure, inc. food
metabolism and dec. inflammation
Overactive
• Cushing’s Syndrome
Underactive
• Addison’s Disease
• Decreased cortisol
and/or aldosterone
production