Primary amenorrhea due to empty sella: an underestimated entity

Dange, Nitin; Redhu, Rakesh; Kawale, Juhi; Mahore, Amit

doi:10.5137/1019-5149.jtn.3901-10.0

Cited by 4 publications

(3 citation statements)

References 10 publications

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“…Related to intracranial hypertension, 10% of these patients were referred to hospital with headache and visual-field defects [ 23 ]. Data from autopsy series and neuroradiological studies reported that primary empty sella accounted for about 5.5% to 35% of those subjects, and it was observed four times frequently in women [ 24 , 25 ]. The peak incidence of PES occurred between the third and fourth decades [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Pituitary Volume in Patients with Primary Empty Sella and Clinical Relevance to Pituitary Hormone Secretion: A Retrospective Single Center Study

Akkuş

Sozutok

Odabaş

et al. 2021

CMIR

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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. Methods: This study was designed retrospectively. 67 patients (55 females, 12 males) diagnosed with primary empty sella syndrome between the years of 2015-2019 were included in the study. Patients were divided into two groups: partial (PES) and total (TES) empty sella by magnetic resonance imaging (MRI). Basal anterior pituitary and its hormones were assessed. We also included 26 healthy control subjects (19 females, 7 males) to compare the differences in pituitary volumes. Volumes were measured by using Osirix Dicom Viewer ( Pixmeo SARL, Geneve, Swiss) in 3.0 Tesla scanner MRI. Results: 82.1% (n=55) of all patients were PES and the others were (n=12) TES. Hypopituitarism, known as one or more pituitary hormones deficiency, was found in 12 patients (17.9%). While 9 of them had total PES, the others had partial PES. Secondary adrenal insufficiency and gonadotropin deficiency were more prevalent in patients with TES. Mean volume measurements of patients with TES, PES and healthy subjects were 0.23±0.17, 0.35±0.15, 0.54±0.17 cm3, respectively. Except for IGF1 values (p=0.026), there was not any significant correlation found between the anterior pituitary hormones and volume measurements. Conclusion: Although volume measurement has helped in the diagnosis of pituitary empty sella (partial or total), it does not seem to have any significant correlation with pituitary secretory function.

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Section: Discussionmentioning

confidence: 99%

Pituitary Volume in Patients with Primary Empty Sella and Clinical Relevance to Pituitary Hormone Secretion: A Retrospective Single Center Study

Akkuş

Sozutok

Odabaş

et al. 2021

CMIR

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“…Detailed laboratory investigations and imaging revealed empty sella syndrome as a cause of their clinical presentations. 7,8 Severe hyponatremia as a manifestation of empty sella syndrome is rare. Severe hyponatremia along with low blood pressure and nausea should raise the possibility of abnormality in pituitary hormones.…”

Section: Discussionmentioning

confidence: 99%

Severe Hyponatremia due to Hypopituitarism Secondary to Empty Sella Syndrome

Shamim¹,

Hayat

Shafqat³

et al. 2021

JRMC

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This case is about a 68 years old patient presented with worsening generalized weakness, dizziness, low mood and reduced appetite with the background history of gout and vitamin D deficiency. On general examination, the patient appeared very lethargic. However, the systemic examination was unremarkable. The vitals check showed a low blood pressure of 104/72 mm Hg. The investigations showed low levels of serum Sodium, Thyroid stimulating hormone, Cortisol. The short Synacthen test was abnormal. The anterior pituitary hormones level showed low levels of Follicle stimulating hormone, Luteinizing hormone and prolactin. CT head with contrast showed enlarged fluid filled pituitary fossa with fat. An MRI Pituitary gland showed an empty sella syndrome. The patient was hydrated initially and electrolytes were monitored regularly. Treated with hydrocortisone and thyroxine to which the patient responded and improved significantly. A follow-up appointment was arranged at endocrine clinic

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“…Dange et al[11] reported a 16-year-old girl with a history of stunted growth and primary amenorrhea, presenting with headache and vomiting. Endocrine testing showed reduced levels of growth hormone, luteinising hormone, and follicular stimulating hormone.…”

Section: Discussionmentioning

confidence: 99%

Rare empty sella syndrome found after postoperative hypotension and respiratory failure: A case report

Guo

Zengjun

et al. 2019

WJCC

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BACKGROUND Empty sella syndrome is a condition in which the pituitary gland shrinks or flattens. Patients with empty sella syndrome often present with headache, hypertension, obesity, visual disturbances, cerebrospinal fluid (CSF) rhinorrhoea, or endocrine dysfunction. Herein, we report a rare case of empty sella syndrome discovered after the patient experienced postoperative hypotension and respiratory failure. CASE SUMMARY A 60-year-old man was admitted for further workup of left shoulder pain. He was assessed by the orthopaedics team and booked for internal fixation of the left clavicle. General anaesthesia with a nerve block was administered. His blood pressure continued to decrease post-operation. Endocrine tests were performed, with the results supporting a diagnosis of hypopituitarism with hypocortisolism and hypothyroidism. Brain magnetic resonance imaging demonstrated that the sella was enlarged and filled with CSF, confirming a diagnosis of empty sella syndrome. The patient was started on endocrine replacement therapy. The patient regained consciousness and spontaneous breath finally. CONCLUSION This case highlights the importance of considering pituitary hormone insufficiency in the context of respiratory and hemodynamic failure during the perioperative period.

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Primary amenorrhea due to empty sella: an underestimated entity

Cited by 4 publications

References 10 publications

Pituitary Volume in Patients with Primary Empty Sella and Clinical Relevance to Pituitary Hormone Secretion: A Retrospective Single Center Study

Pituitary Volume in Patients with Primary Empty Sella and Clinical Relevance to Pituitary Hormone Secretion: A Retrospective Single Center Study

Severe Hyponatremia due to Hypopituitarism Secondary to Empty Sella Syndrome

Rare empty sella syndrome found after postoperative hypotension and respiratory failure: A case report

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