Disputituitarism puberty - youthful

Диспитуитаризм пубертатно – юношеский Disputituitarism pubertal and juvenile (okolopubertatny basophilism, hypothalamic syndrome of puberty, adolescent hypercorticism, obesity with pink strias) is a neuroendocrine syndrome, which is manifested by increased mental and physical fatigue, abnormal increase in body weight, menstrual irregularities in girls and gynecomastia in young men. This syndrome develops against the background of age-related physiological activation of the system: pituitary-hypothalamus-peripheral endocrine glands

Causes

In the majority of recorded cases, dyspitutirism pubertal - youthful is observed in genetically conditioned constitutional - exogenous obesity. To the provoking factors of the development of dyspeptuitarism puberty - youth include: mental and physical trauma, infectious diseases (including neuroinfections), a sharp decrease in the usual physical exertion, the onset of sexual activity. и хронический тонзиллит очень часто сопутствуют диспитуитаризму пубертатно – юношескому. Repeated sore throats and chronic tonsillitis very often accompany dyspeptuitarism puberty - juvenile. However, in most patients, the direct cause of the development of this disease can not be established

Course and symptoms

This syndrome is observed in the same degree as in girls, and in young men from 12 to 23 years (in most cases from 15 to 18 years). A characteristic feature is tall (more often in young men). Uniform obesity of the second - third degree is observed. On the skin of the hips, abdomen, chest, shoulders there are multiple red or pink stretch marks (often superficial, short). In girls there is a violation of the menstrual cycle, and in young men gynecomastia (an increase in mammary glands). Sexual development can be slow, normal or accelerated. Transient hypertension is often noted (in young men more often)

Diagnostics

On the electroencephalogram (EEG) - there are signs of disturbed functioning of nonspecific structures of the diencephalic region and the midbrain. On the radiograph of the skull, areas of calcification of the dura mater, as well as signs of intracranial hypertension, are observed in the "Turkish saddle" area. . In a number of patients, the function of the adrenal cortex was increased, glucose tolerance was impaired, and hyperinsulinism was present. The course of this syndrome is in most cases benign.

и аденомами гипофиза Dyspeptuitarism pubertal - juvenile must be differentiated with the syndrome of Itenko - Cushing and adenomas of the pituitary gland

Treatment

To normalize body weight while reducing other symptoms of the disease, attributed to increased physical activity and a low-calorie diet. When treating in a hospital setting, a specially developed diet is prescribed, which consists of a daily intake of 1200 to 1500 kcal, of which: 80 to 120 grams of carbohydrates, 70 to 80 grams of fat, 80 to 100 grams of protein.

In addition, diuretics, spironolactones, anorectic agents (desopimon, fepranone, etc.), adiposine, thyroid preparations are prescribed. In the presence of symptoms of sexual insufficiency, young men are assigned a chorionic gonadotropin 2 - 4 r. a week to 1500ED, courses of three to four weeks. To improve functional cerebral activity, it is prescribed cerebrolysin, nootropil, cavinton, stugeron, cynarizine (courses 1 to 3 months, 20 to 40 injections per course).

. Treatment of adolescent forms of obesity, among other things, is the prevention of the development of hypertension, diabetes and infertility .

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