Anterior pituitary hormone deficiency in subjects with total and partial primary empty sella: do all cases need endocrinological evaluation?

Zuhur, Sayid Shafi; Kuzu, İdris; Öztürk, Feyza Yener; Uysal, Ender

doi:10.5137/1019-5149.jtn.8671-13.0

Cited by 26 publications

(39 citation statements)

References 11 publications

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“…In five studies involving a total of 343 patients with empty sella, the prevalence of central hypothyroidism was 0-22.2%. [34][35][36][37][38] However, it should be noted that the studies with the highest prevalence of central hypothyroidism (14.3% and 22.2%, respectively) were either a retrospective analysis 34 or analyzed patients admitted to the hospital 38 and, thus, may overestimate the prevalence. The other three studies involving a total of just 87 patients showed a combined prevalence of central hypothyroidism of just 3.4%.…”

Section: Hypothalamic And/or Pituitary Diseasementioning

confidence: 99%

Biochemical Testing of the Thyroid: TSH is the Best and, Oftentimes, Only Test Needed – A Review for Primary Care

Sheehan

2016

Clin Med Res

148

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Disorders of thyroid function are common, and screening, diagnosis, and management are often performed by primary care providers. While management of significant biochemical abnormalities is reasonably straight forward, laboratory tests only slightly outside, or even within, the normal range are becoming more difficult to appropriately manage. A large part of this increasing difficulty in appropriate management is caused by patients requesting, and even demanding, certain tests or treatments that may not be indicated. Symptoms of thyroid dysfunction are non-specific and extremely prevalent in the general population. This, along with a growing body of information available to patients via the lay press and internet suggesting that traditional thyroid function testing is not reliable, has fostered some degree of patient mistrust. Increasingly, when a physician informs a patient that their thyroid is not the cause of their symptoms, the patient is dissatisfied and even angry. This review aims to clarify the interpretation of normal and mild abnormalities of thyroid function tests by describing pituitarythyroid physiology and through an in depth review of, arguably, the three most important biochemical tests of thyroid function: TSH, free T4, and anti-TPO antibodies. It is important for primary care providers to have an understanding of the shortcomings and proper interpretation of these tests to be better able to discuss thyroid function with their patients.

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Section: Hypothalamic And/or Pituitary Diseasementioning

confidence: 99%

Biochemical Testing of the Thyroid: TSH is the Best and, Oftentimes, Only Test Needed – A Review for Primary Care

Sheehan

2016

Clin Med Res

148

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“…Basándose en la naturaleza de la función hipofisaria se han realizado diversos trabajos que describen la sintomatología endocrina por la herniación del diafragma selar sobre la hipófisis 2,14 ; se sabe que existe una asociación entre el grado de herniación, ya sea parcial o total, y el grado de hipopituitarismo 4,20 . El desbalance que produce el líquido cefalorraquídeo sobre las estructuras cerebrales involucradas altera su función; la situación del área selar y estructuras cercanas, como el tallo cerebral, de donde emergen diversos pares craneales, puede incidir en la presentación de un conjunto de signos relacionados con los núcleos y con el origen aparente de los pares craneales.…”

Section: Discussionunclassified

Análisis de la probabilidad conjunta y a posteriori entre aracnoidocele selar primario, sus comorbilidades y enfermedad audiovestibular

Delgado-Hernández

Verduzco-Mendoza

Luna-Reyes

et al. 2015

Cirugía y Cirujanos

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“…Other causes include pituitary apoplexy, postpartum pituitary necrosis [Sheehan's syndrome (SS)], empty sella, stroke, traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), and lymphocytic hypopituitarism [1][2][3][4][5][6][7][8][9]. Primary empty sella (PES) is defined as the thinning of the pituitary gland after subarachnoid space herniated into the sella turcica in patients with no history of pituitary tumor, radiotherapy, and surgery [4][5][6]10]. It occurs due to SS or lymphocytic hypophysitis [5,6].…”

Section: Introductionmentioning

confidence: 99%

Clinical evaluation of pituitary insufficiency in adult population

et al. 2020

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Background/aim: This retrospective study aimed to investigate the clinical profile of pituitary insufficiency (PI) in adult population. Materials and methods: One hundred and fifty patients who were diagnosed as having PI between 2012 and 2018 (53.3% female, mean age 48.13 ± 15.83 years) were retrospectively analyzed. Results: Age at diagnosis was higher in females as compared with males (51.13 ± 15.95 vs. 44.70 ± 15.08 years, P = 0.012). The most frequent presenting signs were headache (29.4%) and visual disturbance (19.6%) in general. Females frequently presented with headache (33.3%), whereas males presented with sexual dysfunction (34.4%). The most frequent cause of PI was nonfunctional pituitary adenoma (28.8%) in general population. A frequent cause of PI was Sheehan's syndrome (33.8%) among females and nonfunctional pituitary adenoma (38.6%) among males. Pituitary macroadenoma (75.8%) was frequent in pituitary tumors with PI. 55.3 % of the patients had 4 pituitary hormones deficiencies and 26.0% of patients had 3 pituitary hormones deficiencies. Gonadotropin deficiency was the leading pituitary hormone deficiency. The frequency of posttraumatic PI was 4.7% in the general population. Conclusion: Nonfunctional pituitary adenoma was the most common cause of PI among males and Sheehan's syndrome was a major etiologic factor in females. Sheehan's syndrome remains an important health problem in Turkey although obstetric care has improved. Posttraumatic PI should be considered in the differential diagnosis of idiopathic PI.

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Anterior pituitary hormone deficiency in subjects with total and partial primary empty sella: do all cases need endocrinological evaluation?

Cited by 26 publications

References 11 publications

Biochemical Testing of the Thyroid: TSH is the Best and, Oftentimes, Only Test Needed – A Review for Primary Care

Biochemical Testing of the Thyroid: TSH is the Best and, Oftentimes, Only Test Needed – A Review for Primary Care

Análisis de la probabilidad conjunta y a posteriori entre aracnoidocele selar primario, sus comorbilidades y enfermedad audiovestibular

Clinical evaluation of pituitary insufficiency in adult population

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