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The Pituitary and Neuroendocrine Program at UHealth

Mission and Purpose:

The mission of the Pituitary and Neuroendocrine Program at UHealth is to provide expert, integrated, timely and efficient care to patients with pituitary disorders and to educate future leaders in the field.

Patients with pituitary disease may often feel overwhelmed or confused about their diagnosis. The interaction and information exchange among endocrinologist, ophthalmologist, radiation specialist, nurses and surgeons occurs provides a “one stop” care for our patients within the framework of standardized protocols that are constantly revised. UPit is one of the fundamental component Miami Brain Tumor Initiative of the Miller School of Medicine at UM (http://umbti.med.miami.edu/) that provides multidisciplinary expertise and facilitates patient appointments by consolidating patient care in sequential convenient clinic visits. Our physicians accommodate over 2,000 pituitary-related visits per year. We offer hormonal and radiological evaluation of patients with pituitary disorders utilizing state of the art MRI scanners. Our pituitary surgeons have a vast experience and the latest endoscopic technology that allows for minimal injury during transphenoidal surgery. We also offer petrosal vein sampling for Cushing’s disease. The affiliated University of Miami Endocrine Testing based within the premises of our internationally renowned Diabetes Research Institute facility allows us to perform complex standardized endocrine pituitary testing. Standardization of procedures and protocols is essential for the reliable interpretation of dynamic endocrine testing results that are a key part of the evaluation of patients with pituitary disorders. We work in close proximity with our colleagues in pediatric endocrinology to ensure transition to adult care.

The Pituitary Gland

The pituitary is an endocrine (hormone-producing) small “master gland” located under the base of the brain. It is a major control center for hormone messaging that acts by responding to a brain structure called the hypothalamus. Hormones are essential for many aspects of life. Some send messages to other endocrine glands to tell them to increase or decrease production of their hormones.

The pituitary gland has two parts. The anterior (or front) pituitary produces hormones that affect the breasts, adrenals, thyroid, ovaries and testes, as well as several other hormones. The main glands affected by the posterior (or rear) pituitary are the kidneys by regulating water retention in your body.

The main hormones produced by the pituitary are:

ACTH adrenocorticotropic hormone
ADH anti-diuretic hormone, or vasopressin
FSH follicle-stimulating hormone
GH growth hormone
LH luteinizing hormone
PRL prolactin
TSH thyroid-stimulating hormone

Common disorders that involve the pituitary gland are:

Pituitary tumors/ adenomas
Hypogonadotropic hypogonadism
Craniopharyngiomas
Rathke’s cleft cysts
Acromegaly
Diabetes insipidus
Cushing’s disease
Growth hormone deficiency

Members/Specialists

Our team of doctors at UM includes endocrinologists with interest in pituitary disorders neuroendocrinologists, neurosurgerons with vast expertise on pituitary surgeries, radiation oncologists, interventional neurologists that perform inferior petrosal veins sampling, neuropathologists, nuclear medicine experts, neuro-ophthalmologists from our internationally recognized Bascom Palmer Eye Institute, specialized nurse navigators with knowledge of pituitary disorders and Otolaryngologists (ENT) doctors.

Staff:

Alejandro Ayala Endocrinology/Neuroendocrinology

Atil Kargi Endocrinology/Neuroendocrinology

Ronald Benveniste Neurosurgery

Jaques Morcos Neurosurgery

Roberto Heros Neurosurgery

Evelyn Sklar Neuroradiology

Dileep R. Yavagal Neurology/Endovascular Neurosurgery

Nagy Elsayyad Radiation Oncology

Ricardo Komotar Neurosurgery

Michael Ivan Neurosurgery

Deborah Heros Neuro-oncology

Rita G. Bhatia

Heleven Delgado Pituitary Nurse Navigator

Crystale Marcel Pituitary Nurse Coordinator

Some important information that will allow us to provide better care:

1. Who is your endocrinologist and/or neurosurgeon?

2. Who is the referring doctor?

3. When was your MRI done (less than 6 months)?

4. Do you have the films? MRI of the sella (or pituitary) with and without gadolinium

5. Did you have any blood tests done? When, Which?

6. Have you had pituitary surgery? In what hospital? Do you have any pathology slides?

7. Have you had radiation or gamma knife treatment?

8. Are you pregnant? When was your last menstrual period?

9. Did you do any Laboratory tests? (customary)

• Comprehensive metabolic profile
CBC
• LH, FSH , estradiol (women) testosterone (men)
TSH and free T4
• 24 hour urinary cortisol with creatinine
• early morning Cortisol and ACTH
• Growth hormone and IGF-1
• Prolactin

10. Do you have copies of Imaging Studies? (customary)

MRI of the brain with and without contrast,CT of the Brain

Reviewing and Discussion your results:

With MyUhealthChart, you can access your medical records electronically online. It provides new, convenient methods of communication with your doctor’s office. You can renew prescriptions, send messages, and schedule appointments – all online.

More information:

The Pituitary Society

More about Pituitary Disorders

Patient Education on Acromegaly

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