11,524 results match your criteria Hypopituitarism

The efficacy of pulsatile gonadotropin-releasing hormone therapy in male patients with hypogonadism caused by hypopituitarism.

Ann Palliat Med 2021 Apr;10(4):4642-4651

Department of Endocrinology, Medical School of Chinese People's Liberation Army, The First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.

Background: To evaluate the efficacy of pulsatile gonadotropin-releasing hormone (GnRH) therapy in patients with hypogonadism caused by hypopituitarism so as to guide clinical treatment.

Methods: Clinical manifestations, laboratory examinations, and imaging features were collected from 22 patients with hypopituitarism that led to hypogonadism who were treated with pulsatile GnRH. Data were analyzed and the patients were followed up. Read More

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A 45-year-old female patient with Sheehan's syndrome presenting with imminent adrenal crisis: a case report.

J Med Case Rep 2021 May 8;15(1):229. Epub 2021 May 8.

Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.

Background: Sheehan's syndrome is hypopituitarism due to pituitary gland necrosis resulting from hemorrhagic shock during pregnancy. It is a rare complication with varied manifestations and a considerable delay in diagnosis.

Case Presentation: We describe the case of a 45-year-old Ethiopian woman who presented with generalized fatigue for 18 years which progressed to anorexia, nausea, vomiting, diarrhea, and abdominal pain of 6 years' duration, for which she was treated symptomatically throughout these years. Read More

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Mortality in Acromegalic Patients: Etiology, Trends, and Risk Factors.

Cureus 2021 Apr 2;13(4):e14265. Epub 2021 Apr 2.

Internal Medicine Endocrinology, Armed Forces Hospital, Abha, SAU.

Although acromegaly has been associated with increased mortality rates, evidence shows that the application of the recent treatment modalities has reduced the risk of death in these patients, being comparable with the general population. As a result of the changing trends regarding mortality, the aim is to review the current literature to create enough evidence about the recent trends of mortality in patients with acromegaly. Moreover, this review aims to identify the possible etiology and the related risk factors. Read More

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CyberKnife for the management of Cushing's disease: our institutional experience and review of literature.

Br J Neurosurg 2021 May 6:1-6. Epub 2021 May 6.

Gandak Hospital, Birgunj, Nepal.

Introduction: Surgery is the primary treatment for Cushing's disease(CD). In cases with no biochemical remission after surgical resection or when recurrence occurs after a period of remission stereotactic radiosurgery (SRS) is used as alternative/adjuvant treatment. The aim of this study is to demonstrate the effectiveness of SRS and FSRS(Fractionated stereotactic radiosurgery) for the treatment of CD in a long term follow up. Read More

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A Case of Sheehan Syndrome 7 Years Postpartum with Transaminitis and Hyperlipidemia.

Am J Case Rep 2021 May 5;22:e930908. Epub 2021 May 5.

Internal Medicine, Mayo Clinic Health System - Southwest Minnesota region, Mankato, MN, USA.

BACKGROUND Sheehan syndrome (pituitary necrosis after postpartum hemorrhage) can present in various ways, depending on the hormones that are deficient. There may be a long delay to diagnosis of over a decade because symptoms are often vague and pituitary dysfunction progresses gradually. We describe a case of a patient with acute presentation of Sheehan syndrome 7 years after the obstetric event and with no clear precipitating event. Read More

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The phenotypic spectrum associated with OTX2 mutations in humans.

Eur J Endocrinol 2021 May 1. Epub 2021 May 1.

M Dattani, Genetics and Genomic Medicine Research and Teaching Programme, UCL Great Ormond Street Institute of Child Health, London, United Kingdom of Great Britain and Northern Ireland.

Objective: The transcription factor OTX2 is implicated in ocular, craniofacial, and pituitary development.

Design: We aimed to establish the contribution of OTX2 mutations in congenital hypopituitarism patients with/without eye abnormalities, study functional consequences, and establish OTX2 in the human brain, with a view to investigating the mechanism of action.

Methods: We screened patients from the UK (n=103), international centers (n=24), and Brazil (n=282); 145 were within the septo-optic dysplasia spectrum, and 264 had no eye phenotype. Read More

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Salivary gland tissues and derived primary and metastatic neoplasms: unusual pitfalls in the work-up of sellar lesions. A systematic review.

J Endocrinol Invest 2021 May 3. Epub 2021 May 3.

Neuromed Institute, IRCCS, Pozzilli, IS, Italy.

Purpose: Salivary gland (SG) tissue and derived neoplasms may occur in the sellar region. As the current literature is mostly limited to case reports, the puzzling case of an inflammatory SG removed by transsphenoidal surgery (TS) and mimicking a prolactinoma prompted us to perform the first systematic review of these unusual conditions.

Methods: A systematic literature search was conducted according to the PRISMA guidelines. Read More

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COVID-19 and the pituitary.

Pituitary 2021 May 3. Epub 2021 May 3.

Institute of Endocrine and Metabolic Sciences, San Raffaele Vita-Salute University and IRCC Hospital, Via Olgettina 60, 20132, Milan, Italy.

Background: Despite COVID-19 being identified as severe respiratory viral infection, progressively many relevant endocrine manifestations have been reported greatly contributing to the severity of the clinical presentation. Systemic involvement in COVID-19 is due to the ubiquitous expression of angiotensin-converting enzyme 2 (ACE2) receptor, responsible for the entry in the cells of SARS-CoV-2, Several reports in humans and animal models showed a significant ACE2 mRNA expression in hypothalamus and pituitary cells. Moreover, higher mortality and poorer outcomes have been widely described in COVID-19 patients with obesity, diabetes and vertebral fractures, which are all highly prevalent in subjects with pituitary dysfunctions. Read More

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Prolonged Postoperative Pyrexia and Transient Nonnephrogenic Vasopressin-Analogue-Resistant Polyuria following Endoscopic Transsphenoidal Resection of an Infundibular Epidermoid Cyst.

Case Rep Neurol Med 2021 13;2021:6690372. Epub 2021 Apr 13.

Department of Pathology, Uonuma Kikan Hospital, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Niigata 949-7302, Japan.

Prolonged postoperative pyrexia (PPP) due to Mollaret's meningitis following endoscopic transsphenoidal surgery (eTSS) for an intracranial epidermoid cyst can be confused with postoperative meningeal infection after transsphenoidal resection, especially in the middle of the COVID-19 pandemic. Anosmia, as well as dysgeusia, cannot be evaluated in patients of eTSS for a while after surgery. We report a case of an infundibular epidermoid cyst with post-eTSS Mollaret's meningitis (MM). Read More

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Clinical Characteristics, Management, and Potential Biomarkers of Endocrine Dysfunction Induced by Immune Checkpoint Inhibitors.

Endocrinol Metab (Seoul) 2021 Apr 27;36(2):312-321. Epub 2021 Apr 27.

Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Immune-related adverse events (irAEs) affecting the endocrine glands are among the most frequent irAEs induced by immune checkpoint inhibitors (ICIs) and include hypopituitarism, primary adrenal insufficiency, thyrotoxicosis, hypothyroidism, hypoparathyroidism, and type 1 diabetes mellitus. Since the incidence and clinical features of endocrine irAEs vary according to the ICI used, it is important to understand the characteristics of these irAEs and to manage each one appropriately. Since some endocrine irAEs, including adrenal crisis and diabetic ketoacidosis, are potentially life-threatening, predicting the risk of endocrine irAEs before their onset is critical. Read More

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Pituitary Sarcoidosis in a Pediatric Patient Successfully Treated With Adalimumab and Methotrexate.

J Investig Med High Impact Case Rep 2021 Jan-Dec;9:23247096211012191

Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA.

Neurosarcoidosis is a rare phenomenon in the pediatric population, with only a few cases reported in the literature worldwide. While hypothalamo-pituitary involvement is known to occur, direct infiltration of the pituitary gland and isolated anterior pituitary dysfunction without diabetes insipidus is seldom observed. A high index of suspicion is required for diagnosis of neurosarcoidosis, and treatment can be challenging due to lack of standardized guidelines. Read More

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Delayed Hyponatremia after Transsphenoidal Surgery for Pituitary Adenomas: A Single Institutional Experience.

Brain Tumor Res Treat 2021 Apr;9(1):16-20

Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.

Background: Hyponatremia is a common complication after transsphenoidal surgery (TSS) for pituitary adenomas. This study retrospectively reviewed various clinical factors of pituitary adenoma patients who underwent TSS and aimed to identify possible risk factors of postoperative hyponatremia.

Methods: Total 1,343 patients who underwent TSS for their pituitary adenomas in a single institution were enrolled to this study. Read More

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Apoplexy in sporadic pituitary adenomas: a single referral center experience and mutation analysis.

Arch Endocrinol Metab 2021 Apr 27. Epub 2021 Apr 27.

Centro de Pesquisas em Neuroendocrinologia/Seção de Endocrinologia, Faculdade de Medicina e Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil,

Objective: To analyze the clinical, laboratory, and radiological findings and management of patients with clinical pituitary apoplexy and to screen for aryl hydrocarbon receptor-interacting protein () mutations.

Methods: The clinical findings were collected from the medical records of consecutive sporadic pituitary adenoma patients with clinical apoplexy. Possible precipitating factors, laboratory data, magnetic resonance imaging (MRI) findings and treatment were also analyzed. Read More

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Management of hypopituitarism: a perspective from the Brazilian Society of Endocrinology and Metabolism.

Arch Endocrinol Metab 2021 Feb 24. Epub 2021 Feb 24.

Unidade de Neuroendocrinologia, Laboratório de Endocrinologia Celular e Molecular LIM-25, Divisão de Endocrinologia e Metabolismo, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil.

Hypopituitarism is a disorder characterized by insufficient secretion of one or more pituitary hormones. New etiologies of hypopituitarism have been recently described, including head trauma, cerebral hemorrhage, and drug-induced hypophysitis. The investigation of patients with these new disorders, in addition to advances in diagnosis and treatment of hypopituitarism, has increased the prevalence of this condition. Read More

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February 2021

Role of pituitary stalk and gland radiological status on endocrine function and outcome after endoscopic transsphenoidal surgery for non-functioning pituitary adenomas.

Endocrine 2021 Apr 20. Epub 2021 Apr 20.

Neurosurgery Department, Hospital Universitario La Paz, Paseo de la Castellana, 261, Madrid, 28046, Spain.

Purpose: To investigate endocrine function changes after non-functioning pituitary adenomas (NFPA) transsphenoidal surgery and to search for predictors of hypopituitarism resolution and development.

Methods: We included 117 patients with NFPA who underwent endoscopic transsphenoidal surgery from 2005 to 2019 by two neurosurgeons. Twenty-one patients were excluded because of previous pituitary surgery or radiotherapy. Read More

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Aetiologies and clinical patterns of hypopituitarism in Sudanese children.

Sudan J Paediatr 2021 ;21(1):53-60

Department of Paediatrics and Child Health, Faculty of Medicine, University of Khartoum, Khartoum, Sudan.

There is paucity of reported information regarding aetiology and clinical profile of hypopituitarism from resource-limited countries particularly in populations with high rates of consanguineous marriages. Here, we are reporting the first data on this aspect from Sudan. This is a descriptive, retrospective, hospital-based study, carried out in the two main paediatric endocrinology centres in Sudan (Gafaar Ibn Auf Paediatric Tertiary Hospital and Soba University Hospital, Khartoum) from January 2006 up to December 2014. Read More

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January 2021

Letter to the Editor from Martin-Grace and Crowley: "Myxedema Heart and Pseudotamponade".

J Endocr Soc 2021 May 2;5(5):bvab026. Epub 2021 Mar 2.

Department of Endocrinology, St Vincent's University Hospital and University College Dublin, Dublin 4, Ireland.

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Pituitary metastasis unveiling a lung adenocarcinoma.

Endocrinol Diabetes Metab Case Rep 2021 Feb 26;2021. Epub 2021 Feb 26.

Endocrinology Department, Centro Hospitalar e Universitário do Porto, EPE, Porto, Portugal.

Summary: Pituitary metastasis (PM) can be the initial presentation of an otherwise unknown malignancy. As PM has no clinical or radiological pathognomonic features, diagnosis is challenging. The authors describe the case of a symptomatic PM that revealed a primary lung adenocarcinoma. Read More

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February 2021

Endoscopic extra-capsular resection of a giant pituitary adenoma: how I do it.

Acta Neurochir (Wien) 2021 Apr 16. Epub 2021 Apr 16.

Division of Neurosurgery, Toronto Western Hospital/University Health Network, University of Toronto, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada.

Background: Giant pituitary adenomas are characterized by their large size and potential to invade parasellar and suprasellar regions leading to visual decline and hypopituitarism. Thus, they remain a significant surgical challenge, and gross total removal is only achieved in the minority of cases.

Method: We aim to describe the key surgical steps for endoscopic extra-capsular resection of a giant pituitary adenoma with the aim of achieving complete tumor resection with description of the relevant surgical anatomy, indications and limitations. Read More

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Outcome of pituitary hormone deficits after surgical treatment of nonfunctioning pituitary macroadenomas.

Endocrine 2021 Apr 14. Epub 2021 Apr 14.

Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.

Objectives: Nonfunctionning pituitary macroadenomas (NFPMA) are benign tumors that cause symptoms of mass effects including hypopituitarism. Their primary treatment is transsphenoidal surgery. We aimed to determine the outcome of pituitary hormone deficits after surgical treatment of NFPMA and to identify factors predicting hormonal recovery. Read More

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A Case of Burnt-Out Langerhans Cell Histiocytosis Presenting as Postpartum Hypopituitarism.

AACE Clin Case Rep 2021 Jan-Feb;7(1):47-50. Epub 2020 Dec 28.

Department of Endocrinology, Townsville University Hospital, Douglas, Queensland, Australia.

Objective: To evaluate the case of a woman who presented with central hypogonadism and diabetes insipidus and further developed a persistent cough leading to an unexpected diagnosis of burnt-out Langerhans cell histiocytosis (LCH).

Methods: Clinical and laboratory endocrine evaluation, magnetic resonance imaging, high-resolution computed tomography, and open-lung biopsy results are discussed.

Results: A 28-year-old woman presented at 10 months postpartum with polydipsia, polyuria, and amenorrhea for 3 months. Read More

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December 2020

Genetics of hypogonadotropic hypogonadism.

Transl Androl Urol 2021 Mar;10(3):1401-1409

Tallwood Urology & Kidney Institute, Hartford HealthCare, Hartford, CT, USA.

Male congenital hypogonadotropic hypogonadism (CHH) is a heterogenous group of genetic disorders that cause impairment in the production or action of gonadotropin releasing hormone (GnRH). These defects result in dysfunction of the hypothalamic-pituitary-gonadal hormone axis, leading to low testosterone levels and impaired fertility. Genetic testing techniques have expanded our knowledge of the underlying mechanisms contributing to CHH including over 30 genes to date implicated in the development of CHH. Read More

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Hypoglycemia after bariatric surgery: importance of exhaustive hormonal study.

Endocrinol Diabetes Metab Case Rep 2021 Mar 20;2021. Epub 2021 Mar 20.

Endocrinology and Nutrition, Hospital Universitari Germans Trias I Pujol, Badalona, Spain.

Summary: Hypoglycemia is an uncommon clinical problem in non-diabetic patients or patients not being treated for diabetes mellitus. It is a rare, but well-established complication of bariatric surgery and, in some cases, it can be the only symptom of another medical problem. A 50-year-old woman with a history of partially recovered hypopituitarism after transsphenoidal surgery for a non-functioning pituitary macroadenoma complained about symptomatic hypoglycemia after sleeve gastrectomy surgery. Read More

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[Hypopituitarism after traumatic brain injury].

Rev Med Chil 2020 Dec;148(12):1796-1805

Departamento de Endocrinología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

Hypopituitarism after moderate or severe traumatic brain injury (TBI) is usually underdiagnosed and therefore undertreated. Its course can be divided in an acute phase during the first 14 days after TBI with 50 to 80% risk of hypopituitarism, and a chronic phase, beginning three months after the event, with a prevalence of hypopituitarism that ranges from 2 to 70%. Its pathophysiology has been addressed in several studies, suggesting that a vascular injury to the pituitary tissue is the most important mechanism during the acute phase, and an autoimmune one during chronic stages. Read More

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December 2020

GH-induced LH hyporesponsiveness as a potential mechanism for hypogonadism in male patients with acromegaly.

Endocr J 2021 Apr 9. Epub 2021 Apr 9.

Department of Endocrinology and Metabolism, Toranomon Hospital, Tokyo 105-8470, Japan.

Male patients with acromegaly frequently have hypogonadism. However, whether excess GH affects gonadal function remains unclear. We retrospectively compared clinical features affecting total testosterone (TT) and free testosterone (FT) levels between 112 male patients with acromegaly and 100 male patients with non-functioning pituitary adenoma (NFPA) without hyperprolactinemia. Read More

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IgG4-related hypophysitis.

Endocrine 2021 Apr 10. Epub 2021 Apr 10.

Department of Neurological Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

Hypophysitis is a rare pituitary inflammatory disorder classified in different ways. Immunoglobulin G4-related disease (IgG4-RD), also a rare disease is a systemic fibro-inflammatory condition characterized by infiltration of tissue with IgG4-positive plasma cells; however prevalence of both of them probably is underestimated. In this paper, we present an Iranian patient with biopsy-proven IgG4-related hypophysitis and then review the clinical characteristics, laboratory, imaging, pathologic findings and therapeutic management as well as prognosis of 115 published cases of hypophysitis secondary to IgG4-related disease. Read More

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GnRH agonist-associated pituitary apoplexy: a case series and review of the literature.

Pituitary 2021 Apr 9. Epub 2021 Apr 9.

Neuroendocrine Unit, Massachusetts General Hospital and Department of Medicine, Harvard Medical School, 100 Blossom Street, Cox140, Boston, MA, 02114, USA.

Purpose: To examine the clinical presentation and longitudinal outcome of Pituitary Apoplexy (PA) after gonadotropin-releasing hormone agonist (GnRHa) in a series of patients and compare to prior reports.

Methods: A retrospective chart review was performed on seven patients receiving GnRHa who developed PA. Prior reported cases were analyzed. Read More

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Predicting the location of the preoptic and anterior hypothalamic region by visualizing the thermoregulatory center on fMRI in craniopharyngioma using cold and warm stimuli.

Aging (Albany NY) 2021 Mar 26;13(7):10087-10098. Epub 2021 Mar 26.

Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Hypothalamic nuclei in the preoptic and anterior hypothalamic region (POAH) are critically involved in thermoregulation and neuroendocrine regulation and can be displaced by craniopharyngiomas (CPs). We aimed to locate the POAH by visualizing hypothalamic thermoregulation through task-related functional magnetic resonance imaging (fMRI) to guide hypothalamus protection intraoperatively. Nine adult healthy volunteers (HVs) and thirty-two adult primary CP patients underwent task-related fMRI for POAH localization by warm (60° C) and cold (0° C) cutaneous thermoreceptor stimulation. Read More

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Anterior pituitary function in Rathke's cleft cysts versus nonfunctioning pituitary adenomas.

Endocr J 2021 Apr 3. Epub 2021 Apr 3.

Department of Diabetology and Endocrinology, Kanazawa Medical University, Uchinada 920-0293, Japan.

Although Rathke's cleft cysts (RCCs) are common sellar/parasellar lesions, studies examining pituitary function in patients with nonsurgical RCC are limited. This study aimed to clarify the importance of RCCs, including small nonsurgical ones, as a cause of hypopituitarism by determining the prevalence of pituitary hormone secretion impairment and its relationship to cyst/tumor size in patients with RCC and in those with nonfunctioning pituitary adenoma (NFA). We retrospectively investigated the basal levels of each anterior pituitary hormone, its responses in the stimulation test(s), and cyst/tumor size in patients with RCC (n = 67) and NFA (n = 111) who were consecutively admitted to our hospital for endocrinological evaluation. Read More

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The role of reoperation after recurrence of Cushing's disease.

Best Pract Res Clin Endocrinol Metab 2021 Feb 6:101489. Epub 2021 Feb 6.

USC Pituitary Center, Department of Neurosurgery, Keck School of Medicine of University of Southern California, 1300 N. State Street, Suite 3300, Los Angeles, CA, 90033, USA; Department of Medicine, Division of Endocrinology and Diabetes, Keck School of Medicine of University of Southern California, 1333 San Pablo Street, BMT-B11, Los Angeles, CA, 90033, USA. Electronic address:

Surgical failure or recurrence of Cushing's disease can be treated with medical therapy, radiotherapy, adrenalectomy, and/or repeat transsphenoidal surgery, all of which have their respective benefits and drawbacks. Redo transsphenoidal surgery has been shown to achieve at least short-term remission in about 40-80% of patients and is associated with low rates of morbidity and near-zero mortality, albeit higher rates of postoperative hypopituitarism, diabetes insipidus, and cerebrospinal fluid leak than initial resection. Despite this, recurrence may ensue in 50% of patients. Read More

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February 2021