1,012 results match your criteria hypopituitarism secondary

Isolated Adrenocorticotropic Hormone Deficiency Associated with Severe Hyperkalemia During Pembrolizumab Therapy in a Patient with Ureteral Cancer and an Ileal Conduit: A Case Report and Literature Review.

Am J Case Rep 2021 Jul 15;22:e931639. Epub 2021 Jul 15.

Department of Urology, Uonuma Kikan Hospital, Minamiuonuma, Niigata, Japan.

BACKGROUND Immune checkpoint inhibitors (ICIs) are anticancer medications that enhance the antitumor immune response. The clinical benefit afforded by ICIs, however, can be accompanied by immune-related adverse events (IRAEs). One of the common endocrine IRAEs is hypophysitis, which often causes hypopituitarism with secondary adrenal insufficiency (AI). Read More

View Article and Full-Text PDF

Empty sella syndrome: Multiple endocrine disorders.

Handb Clin Neurol 2021 ;181:29-40

Pituitary Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address:

Empty sella is a pituitary disorder characterized by the herniation of the subarachnoid space within the sella turcica. This is often associated with a variable degree of flattening of the pituitary gland. Empty sella has to be distinguished in primary and secondary forms. Read More

View Article and Full-Text PDF
January 2021

Hypothalamitis and pituitary atrophy.

Handb Clin Neurol 2021 ;181:149-159

Pituitary Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

Hypothalamitis is a rare inflammatory disorder involving the hypothalamus and classified as primary, or isolated, and secondary hypothalamitis. Secondary hypothalamitis although very rare is more common than the primary one and may occur in patients affected by autoimmune diseases such as autoimmune hypophysitis, systemic autoimmune diseases, infective diseases in patients affected by immune-deficit, paraneoplastic encephalitis, or in patients treated with immune checkpoint inhibitors. In accordance with the rarity of this disease, diagnosis and management of hypothalamitis prove to be challenging. Read More

View Article and Full-Text PDF
January 2021

Growth hormone cocktail improves hepatopulmonary syndrome secondary to hypopituitarism: A case report.

World J Clin Cases 2021 Jun;9(18):4852-4858

Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.

Background: Metabolic associated fatty liver disease frequently occurs in patients with hypopituitarism and growth hormone (GH) deficiency. Some patients may develop to hepatopulmonary syndrome (HPS). HPS has a poor prognosis and liver transplantation is regarded as the only approach to cure it. Read More

View Article and Full-Text PDF

Luteal phase deficiency during the early trimester in a case with secondary hypopituitarism following craniopharyngioma resection.

Hexia Xia Wei Zhang

J Obstet Gynaecol Res 2021 Jul 4. Epub 2021 Jul 4.

Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China.

A 31-year-old woman, who had been diagnosed with craniopharyngioma (CP) at the age of 13, suffered secondary hypopituitarism after two surgical resections of CP, receiving supplement of levothyroxine, cortisone, and sequential estrogen and progesterone because of primary amenorrhea. She managed to conceive after ovulation induction with human menopausal gonadotropin. Luteal phase deficiency (LPD) was found during the first trimester, as the progesterone stayed at a low level between 0. Read More

View Article and Full-Text PDF

Complication avoidance protocols in endoscopic pituitary adenoma surgery: a retrospective cohort study in 514 patients.

Pituitary 2021 Jul 2. Epub 2021 Jul 2.

Pacific Neuroscience Institute, 2125 Arizona Ave, Santa Monica, CA, 90404, USA.

Purpose: To evaluate the impact of using consistent complication-avoidance protocols in patients undergoing endoscopic pituitary adenoma surgery including techniques for avoiding anosmia, epistaxis, carotid artery injury, hypopituitarism, cerebrospinal fluid leaks and meningitis.

Methods: All patients undergoing endoscopic adenoma resection from 2010 to 2020 were included. Primary outcomes included 90-day complication rates, gland function outcomes, reoperations, readmissions and length of stay. Read More

View Article and Full-Text PDF

Panhypopituitarism in acute myocardial infarction.

Ann Afr Med 2021 Apr-Jun;20(2):145-149

Department of Cardiology, John Ochsner Heart and Vascular Institute, New Orleans, LA, USA.

While hypopituitarism is known to be associated with increased cardiovascular morbidity and mortality, panhypopituitarism as a complication of myocardial infarction (MI) is very rare. Here, we report a case of rapidly developing empty sella syndrome with florid manifestations of panhypopituitarism after MI (due to critical stenosis in the left anterior descending artery) complicated by cardiogenic shock in a 65-year-old man. The patient was initially stabilized with conservative management of non-ST-elevated MI and cardiogenic shock, but after initial improvement, he again deteriorated with refractory shock (not adequately responding to vasopressors), seizures, hypoglycemia, hyponatremia, hyperkalemia, and metabolic acidosis. Read More

View Article and Full-Text PDF

Hypopituitarism secondary to a pituitary metastasis in a young woman with an invasive breast carcinoma.

Clin Case Rep 2021 Jun 5;9(6):e04175. Epub 2021 May 5.

Department of Endocrinology La Rabta University Hospital Faculty of Medicine University of Tunis El Manar Tunis Tunisia.

Hypopituitarism secondary to a pituitary metastasis is rare and difficult to diagnose since its symptoms are nonspecific. The presence of visual deficits and nerve palsies should suggest the presence of a pituitary metastasis in a cancer patient. Read More

View Article and Full-Text PDF

Characteristics of Nonfunctioning Pituitary Adenomas That Cause Secondary Adrenal Insufficiency.

World Neurosurg 2021 Jun 26. Epub 2021 Jun 26.

Department of Neurosurgery, Osaka University Graduate School of Medicine, Osaka, Japan.

Objective: Secondary adrenal insufficiency (sAI) is a severe endocrinologic complication associated with nonfunctioning pituitary adenoma (NFPA). However, its prevalence is not simply related to tumor size. In this study, we aimed to detect the clinical characteristics of NFPAs that cause sAI. Read More

View Article and Full-Text PDF

Comparison of multimodal surgical and radiation treatment methods for pediatric craniopharyngioma: long-term analysis of progression-free survival and morbidity.

J Neurosurg Pediatr 2021 May 28:1-8. Epub 2021 May 28.

1Division of Pediatric Neurosurgery, Texas Children's Hospital, Department of Neurosurgery, Baylor College of Medicine, Houston.

Objective: The authors compared survival and multiple comorbidities in children diagnosed with craniopharyngioma who underwent gross-total resection (GTR) versus subtotal resection (STR) with radiation therapy (RT), either intensity-modulated radiation therapy (IMRT) or proton beam therapy (PBT). The authors hypothesized that there are differences between multimodal treatment methods with respect to morbidity and progression-free survival (PFS).

Methods: The medical records of children diagnosed with craniopharyngioma and treated surgically between February 1997 and December 2018 at Texas Children's Hospital were reviewed. Read More

View Article and Full-Text PDF

Pituitary volume in patients with Primary Empty Sella and clinical relevance to pituitary hormone secretion: A retrospective single center study.

Curr Med Imaging 2021 May 25. Epub 2021 May 25.

Cukurova University, Faculty of Medicine, Division of Endocrinology, Adana. Turkey.

Background: According to neuroradiological findings, empty sella seems to be deprived of pituitary tissue in sella turcica. Changing size of the pituitary volume is closely related to the occurrence of primary empty sella. The aim of the study is to determine pituitary dysfunction in patients with partial or total primary empty sella and the significance of pituitary volume measurements in these patients. Read More

View Article and Full-Text PDF

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

View Article and Full-Text PDF

Primary hypothalamic lymphoma with clinical findings mimicking pituitary apoplexy: a case report.

J Med Case Rep 2021 May 25;15(1):293. Epub 2021 May 25.

Department of Endocrinology and Metabolism, Kocaeli University College of Medicine, Kocaeli, 41000, Turkey.

Background: Primary central nervous system lymphoma (PCNSL) is a rare but well-known extra-nodal lymphoma, which usually presents with non-Hodgkin B-cell lymphomas. PCNSL is generally located around the ventricle and is often detected as multiple lesions. It is rarely seen in the area of the hypothalamus. Read More

View Article and Full-Text PDF

Impact of Experience on Outcomes After Endoscopic Transsphenoidal Surgery for Acromegaly.

World Neurosurg 2021 Jul 21;151:e1007-e1015. Epub 2021 May 21.

Department of Neurosurgery, Christian Medical College, Vellore, Tamil Nadu, India. Electronic address:

Objective: Acromegaly is a syndrome of metabolic alterations secondary to increased growth hormone levels from a somatotroph pituitary adenoma. A multidisciplinary approach beginning with surgery, followed by adjuvant radiation or medical therapy for residual disease, is considered standard of care. Several factors affect the likelihood of remission after surgery, but the impact of surgical experience on remission rates has not been adequately assessed. Read More

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

View Article and Full-Text PDF
February 2021

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

View Article and Full-Text PDF
December 2020

IgG4-related hypophysitis.

Endocrine 2021 08 10;73(2):270-291. 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

View Article and Full-Text PDF

Traumatic Brain Injury as Frequent Cause of Hypopituitarism and Growth Hormone Deficiency: Epidemiology, Diagnosis, and Treatment.

Front Endocrinol (Lausanne) 2021 15;12:634415. Epub 2021 Mar 15.

Division of Endocrinology, Diabetes and Metabolism, University of Turin, Turin, Italy.

Traumatic brain injury (TBI)-related hypopituitarism has been recognized as a clinical entity for more than a century, with the first case being reported in 1918. However, during the 20 century hypopituitarism was considered only a rare sequela of TBI. Since 2000 several studies strongly suggest that TBI-mediated pituitary hormones deficiency may be more frequent than previously thought. Read More

View Article and Full-Text PDF

Lessons of the month: A challenging presentation of hypopituitarism secondary to an intracerebral aneurysm.

Clin Med (Lond) 2021 03;21(2):e228-e230

University Hospital Lewisham, Lewisham, UK.

A 65-year-old man presented to ambulatory care with a 10-month history of muscle weakness, weight loss, dysphagia and fatigue.Prior to presentation he had been managed in general practice for hypothyroidism with a low T4 level and normal thyroid stimulation hormone (TSH). He was commenced on levothyroxine yet, despite dose titrations, had ongoing symptoms. Read More

View Article and Full-Text PDF

Clinical characteristics of endocrinopathies in Chinese patients with hereditary haemochromatosis.

Diabetes Metab Res Rev 2021 May 4;37(4):e3448. Epub 2021 Apr 4.

Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.

Aims: Hereditary haemochromatosis (HH) is a genetic disorder characterised by systemic iron overload and can lead to end-organ failure. However, very few data on this disorder, especially those on endocrine gland involvement in Chinese populations, are currently available. This study aimed to analyse the clinical features of endocrinopathies in patients with HH to generate concern among endocrinologists and improve the management of this disorder. Read More

View Article and Full-Text PDF

Experience of a Pituitary Clinic for US Military Veterans With Traumatic Brain Injury.

J Endocr Soc 2021 Apr 25;5(4):bvab005. Epub 2021 Jan 25.

Geriatric Research, Education and Clinical Center (GRECC), VA Puget Sound Health Care System, and Department of Medicine, Division of Gerontology & Geriatric Medicine, University of Washington School of Medicine, Seattle, Washington, USA.

Context: Traumatic brain injury (TBI) is considered the "signature" injury of veterans returning from wartime conflicts in Iraq and Afghanistan. While moderate/severe TBI is associated with pituitary dysfunction, this association has not been well established in the military setting and in mild TBI (mTBI). Screening for pituitary dysfunction resulting from TBI in veteran populations is inconsistent across Veterans Affairs (VA) institutions, and such dysfunction often goes unrecognized and untreated. Read More

View Article and Full-Text PDF

Surgical treatment of a 72-year-old patient with headache, hyponatremia and oculomotor nerve palsy: a case report and literature review.

Gland Surg 2021 Jan;10(1):364-370

Department of Neurosurgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.

Pituitary apoplexy is a life-threatening syndrome caused by acute infarction of the pituitary gland. The most common symptoms associated with pituitary apoplexy are headache, nausea, vomiting, visual symptoms, hypopituitarism, and altered mental status. Both oculomotor nerve palsy and hyponatremia are relatively rare complications of pituitary apoplexy. Read More

View Article and Full-Text PDF
January 2021

Psychological well-being and illness perceptions in patients with hypopituitarism.

Pituitary 2021 Aug 19;24(4):542-554. Epub 2021 Feb 19.

Section of Endocrinology, Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.

Objective: The primary aim of the current study was to objectify a spectrum of persisting subjective psychological complaints in patients with hypopituitarism, at least six months after normalizing of the hormonal disturbances. Also, gender differences on these outcomes were investigated. The secondary aim was to identify illness perceptions and causal attributions within this patient group. Read More

View Article and Full-Text PDF

Increased Mortality Risk in Patients With Primary and Secondary Adrenal Insufficiency.

J Clin Endocrinol Metab 2021 Jun;106(7):e2759-e2768

Department of Metabolic Medicine, St. Mary's Hospital, Imperial College NHS trust, London, UK.

Context: Mortality data in patients with adrenal insufficiency are inconsistent, possibly due to temporal and geographical differences between patients and their reference populations.

Objective: To compare mortality risk and causes of death in adrenal insufficiency with an individually matched reference population.

Methods: A retrospective cohort study was done using a UK general practitioner database (CPRD). Read More

View Article and Full-Text PDF

Cardiovascular Disease in Patients With Primary and Secondary Adrenal Insufficiency and the Role of Comorbidities.

J Clin Endocrinol Metab 2021 Apr;106(5):1284-1293

Department of Metabolic Medicine, St. Mary's Hospital, Imperial College NHS trust, London, UK.

Context: Mortality studies have established that cardiovascular disease is the leading cause of death in patients with adrenal insufficiency and the risk is greater than that observed in individually matched controls.

Objective: Here we have performed a detailed analysis of cardiovascular morbidity and mortality, taking account of the role of comorbidities.

Methods: We performed a retrospective cohort study using the Clinical Practice Research Datalink (CPRD), a UK general practitioner database. Read More

View Article and Full-Text PDF