5,033 results match your criteria Pituitary Disease and Pregnancy

Sheehan syndrome.

J Pak Med Assoc 2021 Apr;71(4):1282-12568

Department of Endocrinology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India.

Sheehan syndrome is an underestimated cause of hypopituitarism, which can be either partial or complete. It results from ischaemic necrosis of anterior pituitary during peripartum period leading to loss of one or more pituitary cell lines. Hyperplasia of pituitary gland during pregnancy increases demand for blood supply and at the same time compresses the pituitary gland. Read More

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Hyperprolactinemia, Clinical Considerations, and Infertility in Women on Antipsychotic Medications.

Psychopharmacol Bull 2021 Mar;51(2):131-148

Amber N. Edinoff, Nancy S. Silverblatt, Eden Girma, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Hayley E. Vervaeke, Cassidy C, Horton, Louisiana State University Shreveport School of Medicine. Alan D. Kaye, Treniece N. Eubanks, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Adam Kaye, Jessica S. Kaye, Andrew J. Garcia, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Elisa E. Neuchat, Department of Biological Sciences, Florida International University, Miami, FL. Giustino Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Omar Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Valley Anesthesiology and Pain Consultants - Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA.

Infertility, the inability to establish a clinical pregnancy after 12 months of regular unprotected sexual intercourse, is caused by a wide variety of both male and female factors. Infertility is estimated to affect between 8-12% of couples trying to conceive globally. Female factor infertility can be subdivided into the following broad categories: ovulatory dysfunction, fallopian tubal disease, uterine causes, and oocyte quality. Read More

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Treatment and therapeutic strategies for pituitary apoplexy in pregnancy: a case series.

J Med Case Rep 2021 May 27;15(1):289. Epub 2021 May 27.

Department of Neurosurgery, Tohoku University Graduate School of Medicine, Kohnan Hospital, 4-20-1 Nagamachiminami, Taihaku-ku, Sendai, Miyagi, 982-8523, Japan.

Background: Pregnancy is a known risk factor for pituitary apoplexy, which is life threatening for both mother and child. However, very few clinical interventions have been proposed for managing pituitary apoplexy in pregnancy.

Case Presentation: We describe the management of three cases of pituitary apoplexy during pregnancy and review available literature. Read More

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Non-functioning pituitary adenomas and pregnancy: one-center experience and review of the literature.

Arch Endocrinol Metab 2021 May;64(5):614-622

División Endocrinología, Hospital General de Agudos Dr. Carlos G. Durand, Buenos Aires, Argentina.

The usual clinical presentation of non-functioning pituitary adenoma (NFPA) consists of symptoms of mass effect and hypopituitarism. NFPA is a rare condition in young women and an uncommon complication during pregnancy. We present the outcome of three patients with NFPA during pregnancy. Read More

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Maternal Exposure to Adversity: Impact on the Microbiota-Gut-Brain Axis, Inflammation and Offspring Psychiatric Outcomes.

Mod Trends Psychiatry 2021 6;32:26-39. Epub 2021 May 6.

Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.

Psychosocial stress, driven by a variety of sources and influences, can be ubiquitous in our modern society. Prolonged exposure to these stressors can have detrimental biological and psychological effects; extant findings in childhood adversity indicate that the cumulative effects of exposure to childhood adversity increase risk for developmental delays, altered immune responses, and psychopathology later in life. The pathways by which these effects are conferred continue to be studied. Read More

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Maternal precarity and HPA axis functioning shape infant gut microbiota and HPA axis development in humans.

PLoS One 2021 20;16(5):e0251782. Epub 2021 May 20.

Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.

Background: Early life exposure to adverse environments, and maternal stress in particular, has been shown to increase risk for metabolic diseases and neurobehavioral disorders. While many studies have examined the hypothalamic-pituitary-adrenal axis (HPA axis) as the primary mechanism behind these relationships, emerging research on the brain-gut axis suggests that the microbiome may play a role. In this study, we tested the relationships among maternal precarity and HPA axis dysregulation during the peripartum period, infant gut microbiome composition, and infant HPA axis functioning. Read More

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[Morphological diagnosis of obstetric pulmonary embolism].

Sud Med Ekspert 2021 ;64(3):11-16

Novosibirsk Regional Clinical Bureau of Forensic Medical Expertise, Novosibirsk, Russia.

Pulmonary embolism (PE) is one of the most common fatal complications in a wide variety of pathologies along the most common death causes of the population - diseases of the circulatory system and oncology. The development of PE in the postoperative and postpartum periods can also be fatal. The diagnosis of PE is very difficult and in 50-80% of cases it is not diagnosed at all. 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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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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Apoplexy of microprolactinomas during pregnancy: report of five cases and review of the literature.

Eur J Endocrinol 2021 May 24;185(1):99-108. Epub 2021 May 24.

Université Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction, and Centre de Référence des Maladies Rares de l'Hypophyse, Le Kremlin-Bicêtre, France.

Context: Prolactinomas frequently cause amenorrhoea, galactorrhoea and infertility and require dopamine agonist (DA) treatment to normalize prolactin levels and hence, restore ovulation. The vast majority of female patients harbour microprolactinomas in whom DA treatment is usually discontinued at the time of pregnancy diagnosis and surveillance is generally limited as the symptomatic growth is considered very rare.

Case Descriptions: We report five cases of women harbouring a microprolactinoma in whom symptomatic pituitary apoplexy occurred during pregnancy. 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

Pituitary thyrotoxicosis presenting as abnormal thyroid function testing during pregnancy: a case report.

J Med Case Rep 2021 Apr 4;15(1):173. Epub 2021 Apr 4.

Department of Pathology, Duke University, Durham, NC, USA.

Background: Central hyperthyroidism is a rare form of hyperthyroidism caused by thyrotrope pituitary adenomas. It is characterized by elevated thyroid-stimulating hormone alongside high thyroxine and triiodothyronine. Goiter is the most common symptom of central hyperthyroidism. Read More

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Diabetes Insipidus: Pathogenesis, Diagnosis, and Clinical Management.

Cureus 2021 Feb 23;13(2):e13523. Epub 2021 Feb 23.

Basic Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA.

Diabetes insipidus (DI) is an endocrine condition involving the posterior pituitary peptide hormone, antidiuretic hormone (ADH). ADH exerts its effects on the distal convoluted tubule and collecting duct of the nephron by upregulating aquaporin-2 channels (AQP2) on the cellular apical membrane surface. DI is marked by expelling excessive quantities of highly dilute urine, extreme thirst, and craving for cold water. Read More

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February 2021

Diagnosis and treatment outcomes of Cushing's disease during pregnancy.

Pituitary 2021 Mar 29. Epub 2021 Mar 29.

Department of Obstetrics and Gynecology, Jawaharlal Institute of Post Graduate Medical Education and Research, Dhanvanthri Nagar, Puducherry, India.

Purpose: We report a case of a pregnant woman with Cushing's disease (CD) and performed a systematic review of literature on diagnosis, treatment, maternal and fetal outcomes of CD in pregnancy.

Methods: A PubMed search was performed for manuscripts in English language from inception till June 2020. Cases of CD with hypercortisolism during pregnancy were included and categorized into three groups based on treatment received. Read More

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Pregnancy-associated diabetes insipidus in Japan-a review based on quoting from the literatures reported during the period from 1982 to 2019.

Endocr J 2021 Apr 23;68(4):375-385. Epub 2021 Mar 23.

Komatsu University#, Komatsu 923-0921, Japan.

This Review Article overviews the literature on diabetes insipidus (DI) associated with pregnancy and labor in Japan published from 1982 to 2019. The total number of patients collected was 361, however, only one-third of these cases had detailed pathophysiologic information enabling us to identify the respective etiology and subtype. Pregnancy-associated DI can be divided into 3 etiologies, central (neurogenic) DI, nephrogenic DI, and excess vasopressinase-associated DI. Read More

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[Pituitary Hypertrophy].

No Shinkei Geka 2021 Mar;49(2):301-315

Department of Neurosurgery, Uonuma Kikan Hospital, Uonuma Institute of Community Medicine.

Pituitary adenomas are the most common cause of sellar masses although there are a number of other neoplastic, infectious, inflammatory, developmental, and vascular etiologies that should be considered. Pregnancy promotes a physiological increase in the size of the maternal pituitary gland, especially adenohypophysis. The normal maturation sequence of the pituitary gland apparently involves a period of physiological hypertrophy in teenagers. Read More

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Prenatal exposure to maternal stressful life events and earlier age at menarche: the Raine Study.

Hum Reprod 2021 Jun;36(7):1959-1969

Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia.

Study Question: Is there an association between prenatal exposure to stressful life events and age at menarche, and does childhood BMI mediate this association?

Summary Answer: Girls exposed to prenatal stress had a slightly earlier age at menarche, but this association did not show a dose-response effect and was not mediated by childhood offspring BMI.

What Is Already Known: Prenatal stress may impact on reproductive function in females including age at menarche, but human data are very limited. High childhood BMI is known to be associated with earlier age at menarche. Read More

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Pituitary tumor apoplexy associated with extrapontine myelinolysis during pregnancy: A case report.

Medicine (Baltimore) 2021 Mar;100(10):e25075

Department of Radiology.

Rationale: Pituitary tumor apoplexy (PTA) is a rare clinical syndrome which requires urgent diagnosis and treatment due to its life-threatening consequences. Management of undiagnosed pituitary tumor before pregnancy is a problem during pregnancy.

Patient Concerns: We reported a case with PTA which was not diagnosed before pregnancy presenting with vomiting associated with hyponatremia during the third trimester. Read More

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Multifactorial diabetes insipidus during pregnancy: a challenging diagnosis.

BMJ Case Rep 2021 Mar 15;14(3). Epub 2021 Mar 15.

Hospital de Santa Maria, Serviço de Endocrinologia, Centro Hospitalar Lisboa Norte EPE, Lisboa, Portugal

Diabetes insipidus (DI) is characterised by thirst and polydipsia with hypotonic polyuria. Several forms exist, namely, central or pituitary, nephrogenic and gestational and must be differentiated for adequate treatment. We describe the case of a 41-year-old woman chronically infected with HIV who had been recently medicated with a tenofovir-based antiretroviral treatment and who, at 22 weeks of pregnancy, presented with transient gestational DI. Read More

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Adrenal insufficiency.

Nat Rev Dis Primers 2021 03 11;7(1):19. Epub 2021 Mar 11.

Endocrinology in Charlottenburg, Berlin, Germany.

Adrenal insufficiency (AI) is a condition characterized by an absolute or relative deficiency of adrenal cortisol production. Primary AI (PAI) is rare and is caused by direct adrenal failure. Secondary AI (SAI) is more frequent and is caused by diseases affecting the pituitary, whereas in tertiary AI (TAI), the hypothalamus is affected. Read More

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Long term outcomes of infants born by mothers with thyroid dysfunction during pregnancy.

Acta Biomed 2020 09 15;92(1):e2021010. Epub 2020 Sep 15.

Universiry of Modena and Reggio Emilia.

According to Barker's hypothesis, sub-optimal conditions during gestation might affect the predisposition for diseases in adulthood. Alteration in endocrine functions during pregnancy, such us thyroid function or glucose metabolism, are not exempt. It is well known that subclinical hypothyroidism and thyroperoxidase antibodies-positive euthyroidism during early pregnancy are associated with increased risk of gestational diabetes mellitus and both conditions influence pregnancy outcome and newborn development and metabolism at short and long terms. Read More

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September 2020

The Immune System Can Hear Noise.

Front Immunol 2020 18;11:619189. Epub 2021 Feb 18.

Department of Otolaryngology & Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

As a stressor widely existing in daily life, noise can cause great alterations to the immune system and result in many physical and mental disorders, including noise-induced deafness, sleep disorders, cardiovascular diseases, endocrine diseases and other problems. The immune system plays a major role in maintaining homeostasis by recognizing and removing harmful substances in the body. Many studies have shown that noise may play vital roles in the occurrence and development of some immune diseases. Read More

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February 2021

Cohort profile: the Dutch famine birth cohort (DFBC)- a prospective birth cohort study in the Netherlands.

BMJ Open 2021 03 4;11(3):e042078. Epub 2021 Mar 4.

Epidemiology and Data Science; Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

Purpose: The Dutch famine birth cohort study was set up to investigate the effects of acute maternal undernutrition of the 1944-1945 Dutch famine during the specific stages of gestation on later health, with a particular focus on chronic cardiovascular and metabolic diseases, ageing and mental health.

Participants: The Dutch famine birth cohort consists of 2414 singletons born alive and at term in the Wilhelmina Gasthuis in Amsterdam around the time of the Dutch famine (1943-1947) whose birth records have been kept. The cohort has been traced and studied since 1994, when the first data collection started. Read More

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Laparoscopic Bilateral Adrenalectomy in a Young Female Patient with Recurrent Cushing's Disease.

Case Rep Endocrinol 2021 12;2021:6632436. Epub 2021 Feb 12.

Department of Surgery, Teaching Hospital Peradeniya, Kandy, Sri Lanka.

Introduction: Synchronous bilateral adrenalectomy is undertaken less often due to numerous perioperative challenges and rare circumstances of patients needing this procedure. Bilateral adrenalectomy is an important second-line option for patients with persistent or recurrent hypercortisolism following transsphenoidal surgery for Cushing's disease. Here, we present a challenging case of synchronous laparoscopic bilateral adrenalectomy for a young female patient with recurrent Cushing's disease and fertility wishes. Read More

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February 2021

Three Successful Pregnancies in a Patient with Recurrent Cushing's Disease.

Case Rep Endocrinol 2021 13;2021:5517303. Epub 2021 Feb 13.

Endocrinology Unit, Department of Endocrinology, Farhat Hached University Hospital, Avenue Ibn El Jazzar, Sousse 4000, Tunisia.

The association of pregnancy and Cushing's disease (CD) is rare. A 28-year-old woman was admitted for clinical suspicion of Cushing's syndrome. The investigations confirmed the diagnosis of CD with secondary hypogonadotropic hypogonadism due to an invasive pituitary macroadenoma. Read More

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February 2021

Minipuberty: Looking Back to Understand Moving Forward.

Front Pediatr 2020 18;8:612235. Epub 2021 Jan 18.

Pediatric Unit, Department of Medical and Surgical Sciences of the Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy.

Hypothalamic-pituitary-gonadal (HPG) axis activation occurs three times in life: the first is during fetal life, and has a crucial role in sex determination, the second time is during the first postnatal months of life, and the third is with the onset of puberty. These windows of activation recall the three windows of the "Developmental Origin of Health and Disease" (DOHaD) paradigm and may play a substantial role in several aspects of human development, such as growth, behavior, and neurodevelopment. From the second trimester of pregnancy there is a peak in gonadotropin levels, followed by a decrease toward term and complete suppression at birth. Read More

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January 2021

Pre-term birth in women exposed to Cushing's disease: the baby-cush study.

Eur J Endocrinol 2021 Mar;184(3):469-476

Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Institut Marseille Maladies Rares (MarMaRa), Marseille, France.

Design: Hypercortisolism during pregnancy is a risk factor for prematurity. Long-term exposure to hypercortisolism may lead to permanent comorbidities, such as hypertension or diabetes, even after remission. Our aim was to determine whether women with a history of Cushing's disease (and being eu-, hypo- or hypercortisolic at the time of pregnancy) had the same risks of comorbidities, and especially prematurity, during pregnancy. Read More

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Impact of maternal prenatal stress by glucocorticoids on metabolic and cardiovascular outcomes in their offspring: A systematic scoping review.

PLoS One 2021 22;16(1):e0245386. Epub 2021 Jan 22.

Medicine with Specialization in Internal Medicine and General Medicine, Hochschule Fulda-University of Applied Sciences, Fulda, Germany.

Background: "Stress" is an emerging problem in our society, health care system as well as patient care, worldwide. Especially by focusing on pre-gestational, gestational but also lactation phases "stress" is to be considered as an own trans-generational risk factor which is associated with adverse metabolic as well cardiovascular outcomes in mothers and their children. Hence, the maternal hypothalamic-pituitary-adrenotrophic (HPA) axis may be stimulated by various "stress" mechanisms as well as risk factors leading to an adverse in utero environment, e. Read More

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MANAGEMENT OF ENDOCRINE DISEASE: Thyroid and female infertility: more questions than answers?!

Kris Poppe

Eur J Endocrinol 2021 Apr;184(4):R123-R135

Endocrine Unit, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium.

Severe thyroid dysfunction may lead to menstrual disorders and infertility via direct and indirect interactions with the hypothalamo-pituitary-ovarian axis and the reproductive organs. However, the exact prevalence of infertility in women with thyroid disorders remains unknown. Fertility problems may persist even after restoring normal thyroid function, and then surgery and/or an assisted reproductive technology (ART) may be necessary to obtain a pregnancy. Read More

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