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Thomas Gilliland, Sylvie Dufour, Gerald I Shulman, Kitt Falk Petersen, Sukru H Emre
NAFLD is a common condition linked to obesity, type 2 diabetes, and metabolic syndrome. Simple hepatic steatosis is a risk factor for inflammatory reactions in the liver (NASH), which may lead to cirrhosis. While the mechanism is unclear, NAFLD and NASH are associated with panhypopituitarism, which in the pediatric population often results from craniopharyngioma or pituitary adenoma and the sequelae of treatment, causing hypothyroidism, adrenal insufficiency, hypogonadotropic hypogonadism, and GH deficiency...
October 20, 2016: Pediatric Transplantation
Khalid S Aljabri, Samia A Bokhari, Faisal Y Assiri, Muneera A Alshareef, Patan M Khan
BACKGROUND: Data on pituitary adenoma (PA) prevalence in Saudi Arabia are scarce. OBJECTIVE: To estimate the epidemiology of PA in a well-defined population. DESIGN: Retrospective analysis. SETTING: Departments of Endocrinology and Radiology at King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia. PATIENTS AND METHODS: Radiological and hormonal data of patients with pituitary adenoma by MRI were reviewed for the period January 2008 to December 2015...
September 2016: Annals of Saudi Medicine
Janez Ravnik, Tomaz Smigoc, Gorazd Bunc, Bostjan Lanisnik, Ursa Ksela, Maja Ravnik, Tomaz Velnar
Metastatic tumours to the pituitary gland are rare. The most frequent are metastases from breast and lung. We describe three patients with metastatic tumours: (I) a 54-year-old patient with metastatic renal clear-cell carcinoma and consequent disturbances in visual acuity, cranial nerve paresis and panhypopituitarism, (II) a 60-year-old patient with a diffuse large B-cell lymphoma with panhypopituitarism and diabetes insipidus and (III) a 57-year-old patient with metastasis of breast cancer and panhypopituitarism, visual impairment and cranial nerve paresis...
September 4, 2016: Neurologia i Neurochirurgia Polska
Curtis Hanba, Peter F Svider, Mahdi A Shkoukani, Anthony Sheyn, Jeffrey T Jacob, Jean Anderson Eloy, Adam J Folbe
BACKGROUND: Although there has been extensive study evaluating adult pituitary surgery, there has been scant analysis among children. Our objective was to evaluate a population-based resource to characterize nationwide trends in surgical approach, hospital stay, and complications among children undergoing pituitary surgery. METHODS: The Kids' Inpatient-Database (KID) files (2009/2012) were evaluated for pituitary gland excisions. Procedure, patient demographics, length of inpatient stay, inpatient costs, hospital setting, and surgical complications were analyzed...
September 14, 2016: International Forum of Allergy & Rhinology
Yuta Murakami, Taku Sato, Shinya Jinguji, Yugo Kishida, Tadashi Watanabe, Osamu Suzuki, Kazuhiko Ikeda, Miyuki Homma, Sanae Midorikawa, Kiyoshi Saito
We report a rare case of primary pituitary lymphoma in a 75-year-old immunocompetent woman. The patient was blind in the right eye and presented with visual disturbance in the left eye that started 2 months previously. She also exhibited right third and fifth cranial nerve palsy. Magnetic resonance imaging(MRI)revealed an intrasellar mass lesion with right cavernous sinus invasion and suprasellar extension with compression of the optic chiasm. The mass lesion was isointense on both T1WI and T2WI, and showed less enhancement than a normal pituitary gland on gadolinium-enhanced T1WI...
September 2016: No Shinkei Geka. Neurological Surgery
Sasima Srisukh, Tananun Tanpaibule, Sasisopin Kiertiburanakul, Atthaporn Boongird, Duangkamon Wattanatranon, Theerapol Panyaping, Chutintorn Sriphrapradang
Pituitary tuberculoma is extremely rare, even in endemic regions of tuberculosis and much less frequently as a presentation of pituitary apoplexy. We describe a 25-year-old female presented with sudden onset of headache and vision loss of left eye which mimicking symptoms of pituitary apoplexy. MRI of the pituitary gland showed a rim-enhancing lesion at the intrasellar region extending into the suprasellar area, but absence of posterior bright spot with enhancement of the pituitary stalk. Pituitary hormonal evaluation revealed panhypopituitarism and diabetes insipidus...
2016: IDCases
Masahiro Oishi, Yasuhiko Hayashi, Issei Fukui, Daisuke Kita, Tadao Miyamori, Mitsutoshi Nakada
BACKGROUND: Xanthomatous hypophysitis (XH) is an extremely rare form of primary hypophysitis characterized by infiltration of the pituitary gland by mixed types of inflammatory cells, including foamy cells, plasma cells, and small mature lymphocytes. XH manifests as varying degrees of hypopituitarism. Although several previous reports have denied a possible contribution of autoimmune mechanism, the exact pathogenesis of XH remains unclear. CASE DESCRIPTION: We describe the case of a 72-year-old woman with a history of rheumatoid arthritis and Sjögren's syndrome who presented with panhypopituitarism and diabetes insipidus...
2016: Surgical Neurology International
Marise Ribeiro de Sousa Berriel, Giovanna Aparecida Balarini Lima, Alessandro Severo Alves de Melo, Maria Laura Vasconcelos Dos Santos, Hassan Rahhal, Giselle Fernandes Taboada
The purpose of this case series is to report eight patients with giant prolactinomas emphasizing presentations and a treatment complication. The study group included six men and two women. The median age was 29 years (18-54 years); median serum prolactin level was 4,562 ng/ml (1,543-18,690 ng/ml); three patients (37.5%) had panhypopituitarism; median tumor diameter was 50 mm (41-60 mm). Five patients (62.5%) had visual field defects and three had improvement during treatment; six patients (75%) reached prolactin normalization, with a median time of 10...
July 2016: Arquivos de Neuro-psiquiatria
Seungjoo Lee, Jun Ho Choi, Chang Jin Kim, Jeong Hoon Kim
OBJECT: Hypophysitis is a rare disease entity mimicking a pituitary adenoma. In spite of crucial disease involving a pituitary gland which is a main component of hormonal axis, there have been minimal researches regarding the hypophysitis. In this study, we described the constellation of the preoperative findings including clinical, radiologic, and endocrinologic features, as well as postoperative outcomes of the hypophysitis. METHODS: The authors reviewed the data retrospectively of a total of 2,814 patients who underwent microsurgery due to pituitary mass lesion (Asan Medical Center)...
July 28, 2016: World Neurosurgery
Juan J Chillarón, Mercè Fernández-Miró, Mercè Albareda, Sara Fontserè, Cristina Colom, Lluís Vila, Juan Pedro-Botet, Juana A Flores Le-Roux
: Testosterone deficiency (Td) has been associated with the metabolic syndrome. Few studies have evaluated this condition in type 1 diabetes (T1D). The primary aim of this study was to evaluate the effectiveness of testosterone undecanoate (TU) on insulin sensitivity, glycemic control, anthropometric parameters, blood pressure and lipid profile in patients with Td and T1D. We performed a randomized placebo-controlled multicenter study. INCLUSION CRITERIA: a) age ≥ 18 years; b) autoimmune diabetes; c) Td (total testosterone <10 nmol/L or calculated free testosterone <225 pmol/L and low/normal LH; d) ability to sign informed consent; e) comply with the study protocol...
September 30, 2016: Endocrine Journal
Rabih Hage, Sheila R Eshraghi, Nelson M Oyesiku, Adriana G Ioachimescu, Nancy J Newman, Valérie Biousse, Beau B Bruce
BACKGROUND: Pituitary apoplexy (PA) often presents with acute headache and neuro-ophthalmic manifestations, including ocular motility dysfunction (OMD) from cranial nerve palsies (CNPs). Our goal was to describe the epidemiology and outcomes of OMD in a large, single-center series of patients with PA. METHODS: We conducted a retrospective chart review of all patients with PA seen in our pituitary center between January 1995 and December 2012. Presenting neuro-ophthalmic, endocrine, and radiologic data, as well as neuro-ophthalmology follow-up data, were collected...
October 2016: World Neurosurgery
Talha Qureshi, Fahad Chaus, Louis Fogg, Mona Dasgupta, David Straus, Richard W Byrne
INTRODUCTION: The transsphenoidal endoscopic approach is a relatively new procedure compared to the microscopic approach in pituitary adenoma resection. The endoscopic approach has shown to significantly decrease the rate of complications, time in the operating room and hospital, and patient post-op discomfort. However, this procedure requires the surgeon to make use of different visual and tactile clues that must be developed with experience. Therefore, it is important to understand the learning curve that the surgeon must overcome to become proficient with the endoscopic approach...
June 22, 2016: British Journal of Neurosurgery
Giuseppe Catapano, Matteo de Notaris, Domenico Di Maria, Luis Alonso Fernandez, Giuseppe Di Nuzzo, Vincenzo Seneca, Giuseppina Iorio, Iacopo Dallan
BACKGROUND: The evolution of skull base surgery over the past decade has been influenced by advancement in visualization technology. Recently, as a result of such improvements, three-dimensional (3-D) scopes have been widely used during endoscopic endonasal approaches. In the present study, we describe the use of 3-D stereoscopic endoscope for the treatment of a variety of skull base lesions. METHODS: From January 2010 to June 2015, a 3-D endoscopic endonasal approach (4 and 4...
August 2016: Acta Neurochirurgica
Gonul Guvenc, Ceren Kizmazoglu, Ercan Pinar, Abdülkadir Imre, Ismail Kaya, Hamdi Bezircioglu, Nurullah Yuceer
This retrospective study aimed to define outcomes and complications of endoscopic versus microscopic transsphenoidal surgery in pituitary adenoma. Data of 94 patients who underwent transsphenoidal endoscopic (n = 45) or microscopic surgery (n = 49) between June 2000 and June 2014 for pituitary adenoma, performed at Katip Çelebi University Hospital, were retrospectively analyzed. The patients' symptomatology, type of adenoma, radiologic findings, surgical outcomes, and preoperative and postoperative complications were investigated...
June 2016: Journal of Craniofacial Surgery
Marta Gonzalez Rozas, Lidia Hernanz Roman, Diego Gonzalez Gonzalez, José Luis Pérez-Castrillón
Studies have established a relationship between hypothalamic-pituitary dysfunction and the onset of liver damage, which may occasionally progress to cirrhosis. Patients with hypopituitarism can develop a metabolic syndrome-like phenotype. Insulin resistance is the main pathophysiological axis of metabolic syndrome and is the causal factor in the development of nonalcoholic fatty liver disease (NAFLD). We present the case of a young patient with liver cirrhosis of unknown aetiology that was finally attributed to panhypopituitarism...
2016: Case Reports in Endocrinology
Federica Guaraldi, Ioannis Karamouzis, Rita Berardelli, Valentina D'Angelo, Alessia Rampino, Clizia Zichi, Ezio Ghigo, Roberta Giordano
Adrenal failure secondary to hypothalamic-pituitary disease is a common although underestimated and underdiagnosed condition, with serious consequences. Corticotropin deficiency can be isolated or more frequently occur in association with other pituitary hormones deficiencies. The most frequent endogenous cause of secondary adrenal insufficiency (SAI) is a tumor of the hypothalamic-pituitary region, usually associated with panhypopituitarism secondary to tumor growth or to its treatment with surgery or irradiation...
2016: Frontiers of Hormone Research
Naomi Cook, Jennifer Miller, John Hart
Social and emotional impairment, school dysfunction, and neurobehavioral impairment are highly prevalent in survivors of childhood craniopharyngioma and negatively affect quality of life. As surgical resection of craniopharyngioma typically impairs hypothalamic/pituitary function, it has been postulated that perhaps post-operative deficiency of the hormone oxytocin may be the etiology of social/emotional impairment. Research on the benefits of oxytocin treatment as a hormone facilitating social interaction is well established...
August 1, 2016: Journal of Pediatric Endocrinology & Metabolism: JPEM
Aikaterini Patrona, Kunal S Patel, Evan D Bander, Alpesh Mehta, Apostolos John Tsiouris, Vijay K Anand, Theodore H Schwartz
OBJECTIVE Surgery within the cavernous sinus (CS) remains a controversial topic because of the delicate and complex anatomy. The risk also varies with tumor consistency. Softer tumors such as pituitary adenomas are more likely to be surgically treated, while firm tumors such as meningiomas are often treated with radiosurgery. However, a wide range of pathologies that can involve the CS are amenable to surgery. The authors describe and analyze their results using endonasal endoscopic "medial-to-lateral" approaches for nonadenomatous, nonmeningeal tumors, in relation to the degree of invasion within the CS...
April 29, 2016: Journal of Neurosurgery
Soo Jung Kim, A Ra Ko, Mo Kyung Jung, Ki Eun Kim, Hyun Wook Chae, Duk Hee Kim, Ho-Seong Kim, Ah Reum Kwon
In males, precocious puberty (PP) is defined as the development of secondary sexual characteristics before age 9 years. PP is usually idiopathic; though, organic abnormalities including tumors are more frequently found in male patients with PP. However, advanced puberty in male also can be an important clinical manifestation in tumors. We report 2 cases of rapidly progressive puberty in males, each associated with a germ-cell tumor. First, an 11-year-old boy presented with mild fever and weight loss for 1 month...
March 2016: Annals of Pediatric Endocrinology & Metabolism
Samantha Shankar, Xiao Wu, Vivek B Kalra, Anita J Huttner, Ajay Malhotra
Intracranial ectopic germinomas are often associated with synchronous midline disease. Germinomas involving the corpus callosum are exceedingly rare. The reported imaging appearance is not as varied as one might expect and a review of the literature reveals a few common imaging features amongst most ectopic lesions, including cyst formation. We report a 24-year-old man with panhypopituitarism. Neuroimaging revealed three enhancing lesions involving the pituitary infundibulum, the pineal region, and a parenchymal lesion involving the genu of the corpus callosum...
September 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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