Subclinical haemorrhage in non-functional adenomas

Cébula, H.; Fasciglione, E.; Santin, Mathieu; Todeschi, Julien; Séverac, François; Proust, F.; Dietemann, J.-L.; Goichot, B.

doi:10.1016/j.neuchi.2017.12.001

Cited by 2 publications

(2 citation statements)

References 21 publications

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“…Diabetic microangiopathy, haemodynamic changes, and the pro-thrombotic state that occurs in patients with uncontrolled diabetes could favour pituitary apoplexy [22][23][24]. However, although plausible, some works have not found this association in acute apoplexy [25,26] or subclinical apoplexy [27].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors, Radiological and Clinical Outcomes in Subclinical and Clinical Pituitary Apoplexy

Biagetti

Sarria-Estrada

Cordero

et al. 2022

JCM

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Background: Pituitary apoplexy (PA) can be symptomatic, namely acute apoplexy (APA), or asymptomatic or subclinical (SPA). Objective: To describe the clinical characteristics and evolution of the patients with APA compared to SPA Patients and methods: Retrospective, longitudinal database analysis. Results: We identified 58 patients with PA, and 37 accomplished the inclusion criteria (17 men, median age 47.7 years). A total of 29 (78.4%) had APA (17 underwent surgery, and 12 were conservatively managed), and 8 (21.6%) had SPA. The presence of non-functioning pituitary adenoma (NFPA) odds ratio (OR): 29.36 (95% confidence interval (CI): 1.86–462.36) and the largest size OR 1.10 (95% CI: 1.01–1.2) elevated the risk of having surgery. Hypopituitarism developed in 35.1% without significant differences between APA and SPA. In non-surgical patients, adenoma volume shrunk spontaneously at one year magnetic resonance imaging (MRI), without statistical differences between the conservatively treated and SPA group. Conclusions: APA is more frequent in larger NFPAs, and this subset of patients has a higher risk of surgery. Hypopituitarism is quite frequent even in patients with SPA, and, therefore, long-term follow-up is mandatory. In the non-surgical group, the pituitary tumour shrinkage is clinically relevant after one year of PA. Consequently, surgery indication in NFPA should be delayed and reassessed if patients remain asymptomatic.

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Section: Discussionmentioning

confidence: 99%

Risk Factors, Radiological and Clinical Outcomes in Subclinical and Clinical Pituitary Apoplexy

Biagetti

Sarria-Estrada

Cordero

et al. 2022

JCM

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“…The presence of diabetic microangiopathy and/or hemodynamic abnormalities and the prothrombotic state that occurs in patients with uncontrolled diabetes could favour pituitary apoplexy [ 9 , 10 , 11 ]. However, some reports have not found this association in either acute apoplexy [ 18 , 19 ] or subclinical apoplexy [ 20 ]. Likewise, in relation to hypertension there are published results in favor [ 21 ] and against [ 18 ] its participation as a risk factor for pituitary apoplexy.…”

Section: Methodsmentioning

confidence: 99%

Pituitary Apoplexy: Risk Factors and Underlying Molecular Mechanisms

Biagetti

Simó

2022

IJMS

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Pituitary apoplexy is a rare syndrome, graded from asymptomatic subclinical apoplexy to a life-threatening condition due to pituitary ischemia or haemorrhage of an enlarged pituitary gland. The risk factors and the molecular underlying mechanisms are yet to be elucidated. We provide an overview of the general concepts, the potential factors associated with pituitary adenoma susceptibility for apoplectic events and the molecular mechanisms that could be involved such as HIF-1α/VEGF pathways and metalloproteinases activation, among others. The knowledge of the molecular mechanisms that could participate in the pathogenesis of pituitary apoplexy is crucial to advancement in the identification of future diagnostic tools and therapeutic targets in this rare but sometimes fatal condition.

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Subclinical haemorrhage in non-functional adenomas

Cited by 2 publications

References 21 publications

Risk Factors, Radiological and Clinical Outcomes in Subclinical and Clinical Pituitary Apoplexy

Risk Factors, Radiological and Clinical Outcomes in Subclinical and Clinical Pituitary Apoplexy

Pituitary Apoplexy: Risk Factors and Underlying Molecular Mechanisms

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