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Hypopituitarism Obesity

Bin Tang, Limin Xiao, Shenhao Xie, Guanlin Huang, Zhigang Wang, Dongwei Zhou, Erming Zeng, Tao Hong
OBJECTIVES: Removal of recurrent or residual symptomatic craniopharyngiomas is more challenging than the primary surgery. The extended endoscopic endonasal (EEE) approach has been proposed an alternative surgical route for removal of various suprasellar tumors including craniopharyngiomas currently. In this study, we summarized the operative experience and described the feasibility and advantages of this technique in recurrent or residual symptomatic craniopharyngiomas. PATIENTS AND METHODS: A retrospective review of 15 patients (9 males and 6 females) whom underwent EEE approach between April 2012 and February 2017, were included in this study...
February 6, 2018: Clinical Neurology and Neurosurgery
J Stanik, M Skopkova, D Stanikova, K Brennerova, L Barak, L Ticha, J Hornova, I Klimes, D Gasperikova
Recently, the genetic cause of several syndromic forms of glycemia dysregulation has been described. One of them, MEHMO syndrome, is a rare X-linked syndrome recently linked to the EIF2S3 gene mutations. MEHMO is characterized by Mental retardation, Epilepsy, Hypogonadism/hypogenitalism, Microcephaly, and Obesity. Moreover, patients with MEHMO had also diabetes and endocrine phenotype, but detailed information is missing. We aimed to provide more details on the endocrine phenotype in two previously reported male probands with MEHMO carrying a frame-shift mutation (I465fs) in the EIF2S3 gene...
January 5, 2018: Physiological Research
Varuna Vyas, Anil Kumar, Vandana Jain
Isolated Growth hormone deficiency is an important and treatable cause of short stature. However, it is often difficult to diagnose the condition with certainty due to the lack of a single robust diagnostic test. Short children, other than those with the classical phenotype of immature chubby facies, truncal obesity and micropenis in boys, or those with history of cranial lesions with known association with hypopituitarism, should be evaluated for growth hormone deficiency only after excluding the other more common conditions...
November 15, 2017: Indian Pediatrics
Victor J Geraedts, Cornelie D Andela, Günter K Stalla, Alberto M Pereira, Wouter R van Furth, Caroline Sievers, Nienke R Biermasz
BACKGROUND: Quality of life (QoL) in patients with acromegaly is reduced irrespective of disease state. The contributions of multifactorial determinants of QoL in several disease stages are presently not well known. OBJECTIVE: To systematically review predictors of QoL in acromegalic patients. METHODS: Main databases were systematically searched using predefined search terms for potentially relevant articles up to January 2017. Inclusion criteria included separate acromegaly cohort, non-hereditary acromegaly, QoL as study parameter with clearly described method of measurement and quantitative results, N ≥ 10 patients, article in English and adult patients only...
2017: Frontiers in Endocrinology
Manuela Trotta, Joël Da Broi, Angelo Salerno, Rosa M Testa, Giuseppe M Marinari
The aim of this study is to investigate the effects of sleeve gastrectomy on hormone replacement therapy and on hypothalamic obesity in patients affected by craniopharyngioma with post-surgical pan-hypopituitarism. A retrospective review of three patients, treated for hypothalamic obesity with laparoscopic sleeve gastrectomy, who have previously undergone surgery for craniopharyngioma in their childhood, was done. Patients' mean age and BMI were 22.3 years (range 21-24) and 49.2 kg/m(2) (range 41.6-58.1), respectively...
March 2017: Updates in Surgery
Mark E Molitch
Importance: Pituitary adenomas may hypersecrete hormones or cause mass effects. Therefore, early diagnosis and treatment are important. Observations: Prevalence of pituitary adenomas ranges from 1 in 865 adults to 1 in 2688 adults. Approximately 50% are microadenomas (<10 mm); the remainder are macroadenomas (≥10 mm). Mass effects cause headache, hypopituitarism, and visual field defects. Treatments include transsphenoidal surgery, medical therapies, and radiotherapy...
February 7, 2017: JAMA: the Journal of the American Medical Association
Ah Reum Khang, Eu Jeong Ku, Ye An Kim, Eun Roh, Jae Hyun Bae, Tae Jung Oh, Sang Wan Kim, Chan Soo Shin, Seong Yeon Kim, Jung Hee Kim
PURPOSE: Hypopituitary patients have a reduced life expectancy owing to cardiovascular events. We investigated the prevalence of metabolic syndrome in hypopituitary patients for a follow-up period of at least 1 year in comparison with an age- and sex-matched nationwide control group. METHODS: A total of 515 patients with hypopituitarism who visited Seoul National University Hospital between January 2000 and December 2010 were included. Data for an age- and sex-matched control group were obtained from the Korean National Health and Nutrition Examination Surveys (KNHANES) (n = 1545)...
December 2016: Pituitary
Sogol Mostoufi-Moab, Kristy Seidel, Wendy M Leisenring, Gregory T Armstrong, Kevin C Oeffinger, Marilyn Stovall, Lillian R Meacham, Daniel M Green, Rita Weathers, Jill P Ginsberg, Leslie L Robison, Charles A Sklar
PURPOSE: The development of endocrinopathies in survivors of childhood cancer as they age remains understudied. We characterized endocrine outcomes in aging survivors from the Childhood Cancer Survivor Study on the basis of therapeutic exposures. PATIENTS AND METHODS: We analyzed self-reported conditions in 14,290 5-year survivors from the Childhood Cancer Survivor Study, with a median age 6 years (range, < 1 to 20 years) at diagnosis and 32 years (range, 5 to 58 years) at last follow-up...
September 20, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Syed S Mahmood, Anju Nohria
Cancer survivors who receive head and neck radiation are at increased risk for cerebrovascular events. This is mediated via damage to the hypothalamus-pituitary axis leading to the metabolic syndrome and extracranial arterial injury leading to carotid artery stenosis. Head and neck radiation can also lead to intracranial injury that can present as moyamoya, especially in children. Survivors require lifelong periodic follow-up for the development of pan-hypopituitarism or its individual components as well as for dyslipidemia and obesity...
July 2016: Current Treatment Options in Cardiovascular Medicine
Emilio García García, Catalina Márquez Vega, Manuel Fajardo Cascos, Eva Venegas Moreno, Alfonso Soto Moreno
BACKGROUND AND OBJECTIVES: To describe the frequency of endocrine disorders in children with optic chiasm glioma and analyze related factors. PATIENTS AND METHODS: Review of medical records by collecting sex, age, history of neurofibromatosis, clinical presentation, treatment of tumour, and presence of endocrine abnormalities. Statistical tests Wilcoxon and Fisher. RESULTS: 14 patients (6 female) with age at diagnosis of 0.5 to 7.0 years (mean±standard deviation: 2...
May 20, 2016: Medicina Clínica
C Pelusi, D I Gasparini, N Bianchi, R Pasquali
Hereditary hemochromatosis (HH) is a genetic disorder of iron overload and subsequent organ damage. Five types of HH are known, classified by age of onset, genetic cause, clinical manifestations and mode of inheritance. Except for the rare form of juvenile haemochromatosis, symptoms do not usually appear until after decades of progressive iron loading and may be triggered by environmental and lifestyle factors. Despite the last decades discovery of genetic and phenotype diversity of HH, early studies showed a frequent involvement of the endocrine glands where diabetes and hypogonadism are the most common encountered endocrinopathies...
August 2016: Journal of Endocrinological Investigation
Carly Stewart, Pamela Garcia-Filion, Cassandra Fink, Anna Ryabets-Lienhard, Mitchell E Geffner, Mark Borchert
BACKGROUND: Hypopituitarism and obesity are causes of major lifelong morbidity in patients with optic nerve hypoplasia (ONH). Growth hormone deficiency (GHD) affects the majority of children with ONH, though the degree of deficiency and variability of early growth patterns range from early severe retardation to normal initial growth. The utility of early GH replacement for improving anthropometric, body composition, and lipid outcomes in patients with ONH and GHD, especially those with normal initial height velocity, is unknown...
2016: International Journal of Pediatric Endocrinology
Peter Wolf, Yvonne Winhofer, Sabina Smajis, Renate Kruschitz, Karin Schindler, Alois Gessl, Michaela Riedl, Greisa Vila, Wolfgang Raber, Felix Langer, Gerhard Prager, Bernhard Ludvik, Anton Luger, Michael Krebs
OBJECTIVE: Craniopharyngiomas (CPs) are benign brain tumors presenting frequently in childhood and are treated by surgery with or without radiotherapy. About 50% of cured patients suffer from eating disorders and obesity due to hypothalamic damage, as well as hypopituitarism, necessitating subsequent hormone substitution therapy. Gastric bypass surgery has been reported to be an efficient treatment strategy for morbid hypothalamic obesity. However, so far it is unknown whether oral hormone substitution is affected by impaired intestinal drug absorption, potentially leading to severe hypopituitarism or pituitary crisis...
May 2016: Endocrine Practice
Jessica R Wilson, Andrea L Utz, Jessica K Devin
OBJECTIVE: Body weight blunts the growth hormone (GH) response to provocative stimuli. The appropriate GH cut-off to confirm GH deficiency in obese and overweight patients undergoing the glucagon stimulation test (GST) has recently been questioned. We hypothesized that the peak GH would be inversely related to the nadir blood glucose (BG) after glucagon and that this may be a mechanism influencing peak GH in overweight patients. This retrospective study examined effects of gender, body weight, and BG dynamics on GH response to GST in patients evaluated in our Pituitary Center...
February 2016: Growth Hormone & IGF Research
Terhi Partanen, Minna Koivikko, Päivi Leisti, Pasi Salmela, Eija Pääkkö, Ari Karttunen, Harri Sintonen, Leila Risteli, Nina Hautala, Olli Vapalahti, Antti Vaheri, Heikki Kauma, Timo Hautala
OBJECTIVE: Nephropathia epidemica (NE) is a haemorrhagic fever with renal syndrome (HFRS) caused by Puumala hantavirus (PUUV). Pituitary haemorrhage and hypopituitarism may complicate recovery from acute NE. DESIGN: Forty-seven of our recent cohort of 58 NE patients volunteered to be re-examined in order to estimate the burden of hormonal deficiency 4 to 8 years after the acute illness. Two patients had suffered from pituitary haemorrhage, but many others exhibited pituitary oedema during their acute infection...
January 2016: Clinical Endocrinology
Iris Crespo, Alicia Santos, Susan M Webb
PURPOSE OF REVIEW: Quality of life (QoL) is impaired in patients with adults with growth hormone deficiency (AGHD) of any cause, especially if additional hypopituitarism is present, and improves after replacement therapy with recombinant human growth hormone (rhGH). This review includes relevant publications since 2013. RECENT FINDINGS: Recent findings confirm that most patients with AGHD who improve their QoL after rhGH therapy experience persistent effects for years, if replacement therapy is maintained...
August 2015: Current Opinion in Endocrinology, Diabetes, and Obesity
Atsushi Fujio, Naoki Kawagishi, Taketora Echizenya, Kazuaki Tokodai, Chikashi Nakanishi, Shigehito Miyagi, Kazushige Sato, Keisei Fujimori, Noriaki Ohuchi
Nonalcoholic steatohepatitis (NASH) is the most severe form of nonalcoholic fatty liver disease (NAFLD). In adult patients, liver transplantation (LT) is the treatment of choice for end-stage liver disease secondary to NASH. However, little information is available regarding outcomes of LT in pediatric patients with NASH. We describe here a pediatric patient with NASH associated with hypopituitarism who underwent living donor liver transplantation (LDLT). An 11-year-old boy was diagnosed with a pituitary tumor, which was removed by trans-interhemispheric approach following bifrontal craniotomy...
January 2015: Tohoku Journal of Experimental Medicine
Wassim Chemaitilly, Zhenghong Li, Sujuan Huang, Kirsten K Ness, Karen L Clark, Daniel M Green, Nicole Barnes, Gregory T Armstrong, Matthew J Krasin, Deo Kumar Srivastava, Ching-Hon Pui, Thomas E Merchant, Larry E Kun, Amar Gajjar, Melissa M Hudson, Leslie L Robison, Charles A Sklar
PURPOSE: To estimate the prevalence of and risk factors for growth hormone deficiency (GHD), luteinizing hormone/follicle-stimulating hormone deficiencies (LH/FSHD), thyroid-stimulatin hormone deficiency (TSHD), and adrenocorticotropic hormone deficiency (ACTHD) after cranial radiotherapy (CRT) in childhood cancer survivors (CCS) and assess the impact of untreated deficiencies. PATIENTS AND METHODS: Retrospective study in an established cohort of CCS with 748 participants treated with CRT (394 men; mean age, 34...
February 10, 2015: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Muhammad Jaffar Khan, Khadija Nuzhat Humayun, Malcolm Donaldson, S Faisal Ahmed, M Guftar Shaikh
OBJECTIVE: We investigated the relationship of body mass index at presentation and pituitary status with long-term changes in BMI over a period of 5 years. STUDY DESIGN: Craniopharyngioma patients (n = 25) attending a tertiary pediatric endocrine center were divided into three groups based on their BMI at presentation [BMI ≥ 2 standard deviation scores (SDS), 0-1.99 SDS, and <0 SDS) and then analyzed for trends of BMI over a period of up to 5 years. RESULTS: Median (interquartile range) BMI SDS and hypopituitarism at presentation versus at the 5-year follow-up were as follows: BMI SDS ≥ 2 group (n = 10): 3...
2014: Hormone Research in Pædiatrics
Claudia Giavoli, Claudia Tagliabue, Eriselda Profka, Laura Senatore, Silvia Bergamaschi, Giulia Rodari, Anna Spada, Paolo Beck-Peccoz, Susanna Esposito
BACKGROUND: A number of studies of adults have shown that pituitary deficiencies can develop in a considerable proportion of subjects during the acute phase of meningitis or years after the infection has disappeared. The results of the very few studies of the impact of pediatric meningitis on hypothalamic-pituitary function are conflicting. METHODS: In order to determine the incidence of pituitary dysfunction in children with central nervous system infection, we evaluated pituitary function and anthropometric parameters in 19 children with meningitis of different etiologies (15 males; mean age ± standard deviation [SD] at pituitary evaluation, 5...
October 6, 2014: BMC Endocrine Disorders
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