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Secondary hypopituitarism

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https://www.readbyqxmd.com/read/28596421/higher-glucocorticoid-replacement-doses-are-associated-with-increased-mortality-in-patients-with-pituitary-adenoma
#1
Casper Hammarstrand, Oskar Ragnarsson, Tobias Hallén, Eva Andersson, Thomas Skoglund, Anna G Nilsson, Gudmundur Johannsson, Daniel S Olsson
OBJECTIVE: Patients with secondary adrenal insufficiency (AI) have an excess mortality. The objective was to investigate the impact of the daily glucocorticoid replacement dose on mortality in patients with hypopituitarism due to non-functioning pituitary adenoma (NFPA). METHOD: Patients with NFPA were followed between years 1997- 2014 and cross-referenced with the National Swedish Death Register. Standardized mortality ratio (SMR) was calculated with the general population as reference and Cox-regression was used to analyse the mortality...
June 8, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28552871/a-case-of-stiff-person-syndrome-due-to-secondary-adrenal-insufficiency
#2
Yuri Mizuno, Hiroo Yamaguchi, Taira Uehara, Kenichiro Yamashita, Ryo Yamasaki, Jun-Ichi Kira
We report a case of flexion contractures in a patient's legs secondary to postpartum hypopituitarism. A 56-year-old woman presented with a 3-year history of worsening flexion contractures of the hips and knees. On admission, her hips and knees could not be extended, and she had muscle stiffness and tenderness to palpation of the lower extremities. We first suspected stiff-person syndrome or Isaacs' syndrome because of her muscle stiffness. However, multiple hormones did not respond to stimulation tests, and an MRI of the brain showed atrophy of the pituitary gland with an empty sella...
May 26, 2017: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/28552700/analysis-of-factors-related-to-hypopituitarism-in-non-sellar-intracranial-tumor-patients
#3
Song-Song Lu, Jian-Jun Gu, Xiao-Hong Luo, Jian-He Zhang, Shou-Sen Wang
OBJECTIVES: Previous studies have suggested that postoperative hypopituitarism in patients with non-sellar intracranial tumors is caused by traumatic surgery. However, with development of minimally invasive and precise neurosurgical techniques, the degree of injury to brain tissue has been reduced significantly, especially for parenchymal tumors. Therefore, understanding pre-existing hypopituitarism and related risk factors can improve perioperative management for patients with non-sellar intracranial tumors...
May 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28472507/a-case-report-of-hypoglycemia-and-hypogammaglobulinemia-david-syndrome-in-a-patient-with-a-novel-nfkb2-mutation
#4
Rayhan A Lal, Laura K Bachrach, Andrew R Hoffman, Jingga Inlora, Shannon Rego, Michael P Snyder, David B Lewis
Context: DAVID syndrome (Deficient Anterior pituitary with Variable Immune Deficiency) is a rare disorder in which children present with symptomatic ACTH deficiency preceded by hypogammaglobulinemia from B-cell dysfunction with recurrent infections, termed common variable immunodeficiency (CVID). Subsequent whole exome sequencing studies have revealed germline heterozygous C-terminal mutations of NFKB2 as either a cause of DAVID syndrome or of CVID without clinical hypopituitarism. However, to the best of our knowledge there have been no cases in which the endocrinopathy has presented in the absence of a prior clinical history of CVID...
May 3, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28443262/a-rare-association-of-central-hypothyroidism-and-adrenal-insufficiency-in-a-boy-with-williams-beuren-syndrome
#5
Devi Dayal, Dinesh Giri, Senthil Senniappan
Primary hypothyroidism related to morphological and volumetric abnormalities of the thyroid gland is one of the commonest of several endocrine dysfunctions in Williams-Beuren syndrome (WBS). We report a 10-month-old boy with WBS who presented with central hypothyroidism. During the neonatal period, he had prolonged jaundice, feeding difficulties and episodes of colic that continued during early infancy. Additionally, there was slowing of growth and mild developmental delay. He underwent surgical repair for supravalvular aortic stenosis at 6 months of age...
March 2017: Annals of Pediatric Endocrinology & Metabolism
https://www.readbyqxmd.com/read/28382019/transcriptome-analysis-showed-a-differential-signature-between-invasive-and-non-invasive-corticotrophinomas
#6
Leonardo Jose Tadeu de Araújo, Antonio Marcondes Lerario, Margaret de Castro, Clarissa Silva Martins, Marcello Delano Bronstein, Marcio Carlos Machado, Ericka Barbosa Trarbach, Maria Candida Barisson Villares Fragoso
ACTH-dependent hypercortisolism caused by a pituitary adenoma [Cushing's disease (CD)] is the most common cause of endogenous Cushing's syndrome. CD is often associated with several morbidities, including hypertension, diabetes, osteoporosis/bone fractures, secondary infections, and increased cardiovascular mortality. While the majority (≈80%) of the corticotrophinomas visible on pituitary magnetic resonance imaging are microadenomas (MICs, <10 mm of diameter), some tumors are macroadenomas (MACs, ≥10 mm) with increased growth potential and invasiveness, exceptionally exhibiting malignant demeanor...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28365624/getting-to-the-heart-of-hypopituitarism
#7
Julie Martin-Grace, Mohamed Ahmed, Niall Mulvihill, Eoin R Feeney, Rachel K Crowley
A 53-year-old woman was diagnosed with hypopituitarism following an acute presentation with cardiac tamponade and hyponatraemia, having recently been investigated for a pericardial effusion. Secondary hypothyroidism is a rare cause of pericardial effusion and tamponade, but an important differential to consider. Management requires appropriate hormone replacement and, critically, a low threshold for commencing stress dose steroids. Clinical signs classically associated with cardiac tamponade are frequently absent in cases of tamponade due to primary and secondary hypothyroidism, and the relatively volume deplete state of secondary hypoadrenalism in hypopituitarism may further mask an evolving tamponade, as the rise in right atrial pressure is less marked even in the presence of large effusion...
April 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28217586/occult-endocrine-dysfunction-in-patients-with-cirrhosis-of-liver
#8
K V S Hari Kumar, A K Pawah, Manish Manrai
BACKGROUND: Liver dysfunction leads to endocrine disturbance due to the alteration in protein metabolism or synthesis. We studied the presence of occult endocrine dysfunction in liver cirrhosis and compared the same with underlying etiology. MATERIALS AND METHODS: We evaluated thirty patients with liver cirrhosis in this cross-sectional, observational study. All subjects were assessed for pituitary, thyroid, adrenal, and gonadal function. The patients were divided into Group 1 (cirrhosis, n = 30) and Group 2 (controls, n = 15) and the data were analyzed with appropriate statistical tests...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28217503/pituitary-dysfunction-in-traumatic-brain-injury-is-evaluation-in-the-acute-phase-worthwhile
#9
Pradip P Dalwadi, Nikhil M Bhagwat, Parimal S Tayde, Ameya S Joshi, Premlata K Varthakavi
INTRODUCTION: Traumatic brain injury (TBI) is an under-recognized cause of hypopituitarism. According to recent data, it could be more frequent than previously known. However, there is a scarcity of data in Indian population. AIMS: The main aim of the study was to determine the prevalence of pituitary hormone deficiencies in the acute phase of TBI. The secondary objectives were to correlate the severity of trauma with basal hormone levels and to determine whether initial hormone deficiencies predict mortality...
January 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28210908/updates-in-outcomes-of-stereotactic-radiation-therapy-in-acromegaly
#10
REVIEW
Monica Livia Gheorghiu
Purpose Treatment of acromegaly has undergone important progress in the last 20 years mainly due to the development of new medical options and advances in surgical techniques. Pituitary surgery is usually first-line therapy, and medical treatment is indicated for persistent disease, while radiation (RT) is often used as third-line therapy. The benefits of RT (tumor volume control and decreased hormonal secretion) are hampered by the long latency of the effect and the high risk of adverse effects. Stereotactic RT methods have been developed with the aim to provide more precise targeting of the tumor with better control of the radiation dose received by the adjacent brain structures...
February 2017: Pituitary
https://www.readbyqxmd.com/read/28153622/case-report-of-a-primary-pituitary-abscess-and-systematic-literature-review-of-pituitary-abscess-with-a-focus-on-patient-outcomes
#11
REVIEW
Justice O Agyei, Lindsay J Lipinski, Jody Leonardo
BACKGROUND: Pituitary abscess is a rare but potentially life-threatening condition with an incidence of 0.2%-1.1% of operative pituitary lesions. Diagnosis can be challenging, because this disorder shares many similarities with other pituitary lesions in terms of signs and symptoms and radiographic findings. Most pituitary abscesses are categorized as secondary, arising from preexisting pituitary lesions or in conjunction with transsphenoidal surgery, sepsis, meningitis, or sinusitis...
May 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28018694/anterior-hypopituitarism-and-treatment-response-in-hunter-syndrome-a-comparison-of-two-patients
#12
Munier A Nour, Paola Luca, David Stephure, Xing-Chang Wei, Aneal Khan
Hypopituitarism is a clinically important diagnosis and has not previously been reported in Hunter syndrome. We contrast two cases with anatomic pituitary anomalies: one with anterior panhypopituitarism and the other with intact pituitary function. Patient 1, a 10-year-old boy with Hunter syndrome, was evaluated for poor growth and an ectopic posterior pituitary gland. Endocrine testing revealed growth hormone (GH) deficiency, secondary adrenal insufficiency, and tertiary hypothyroidism. An improvement in growth velocity with hormone replacement (GH, thyroxine, and corticosteroid) was seen; however, final adult height remained compromised...
2016: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/27891281/septooptic-dysplasia-with-an-associated-arachnoid-cyst
#13
Skyler V McLaurin-Jiang, Julie K Wood, David F Crudo
A 4-week-old male infant presented with hypothermia, hypoglycemia, and hyperbilirubinemia. His medical history was remarkable for hydrocephalus secondary to an arachnoid cyst, intermittent hypoglycemia, hypothermia, and poor feeding requiring nasogastric tube for nutrition. Physical exam revealed retrognathia, mild hypotonia, micropenis, and clinodactyly. Ophthalmologic exam demonstrated bilateral optic nerve hypoplasia (ONH). Laboratory data confirmed inadequate cortisol and growth hormone response to hypoglycemia, a low thyroxine level, and direct hyperbilirubinemia...
2016: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/27843654/anterior-pituitary-aplasia-in-an-infant-with-ring-chromosome-18p-deletion
#14
Edward J Bellfield, Jacqueline Chan, Sarah Durrin, Valerie Lindgren, Zohra Shad, Claudia Boucher-Berry
We present the first reported case of an infant with 18p deletion syndrome with anterior pituitary aplasia secondary to a ring chromosome. Endocrine workup soon after birth was reassuring; however, repeat testing months later confirmed central hypopituitarism. While MRI reading initially indicated no midline defects, subsequent review of the images confirmed anterior pituitary aplasia with ectopic posterior pituitary. This case demonstrates how deletion of genetic material, even if resulting in a chromosomal ring, still results in a severe syndromic phenotype...
2016: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/27815769/the-effect-of-growth-hormone-replacement-in-patients-with-hypopituitarism-on-pituitary-tumor-recurrence-secondary-cancer-and-stroke
#15
Sina Jasim, Fares Alahdab, Ahmed T Ahmed, Shrikant U Tamhane, Anu Sharma, Diane Donegan, Todd B Nippoldt, M Hassan Murad
Growth hormone replacement therapy has benefits for patients with hypopituitarism. The safety profile in regard to tumor recurrence or progression, development of secondary malignancies, or cerebrovascular stroke is still an area of debate. A comprehensive search of multiple databases-MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus was conducted through August 2015. Eligible studies that evaluated long-term adverse events in adult patients with hypopituitarism treated with growth hormone replacement therapy and reported development of pituitary tumor recurrence or progression, secondary malignancies, or cerebrovascular stroke were selected following a predefined protocol...
November 4, 2016: Endocrine
https://www.readbyqxmd.com/read/27778105/can-early-clinical-parameters-predict-post-traumatic-pituitary-dysfunction-in-severe-traumatic-brain-injury
#16
O Nemes, N Kovacs, Sz Szujo, B Bodis, L Bajnok, A Buki, T Doczi, E Czeiter, E Mezosi
BACKGROUND: Post-traumatic hypopituitarism is a major complication after severe head trauma. The aim of our study was to evaluate the possible role of early clinical parameters in the development of endocrine deficits. METHODS: Data on endocrine function, on-admission clinical-, laboratory-, and ICU-monitored parameters were available in 63 patients of the surviving 86 severe head injury patients (post-resuscitation GCS under 8) treated at one neurosurgical center during a 10-year period...
December 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27618599/hypopituitarism-and-goitre-as-endocrine-manifestation-of-langerhans-cell-histiocytosis-lch-case-report
#17
Elzbieta Skowronska-Jozwiak, Stanislaw Sporny, Joanna Szymanska-Duda, Dobromila Baranska, Andrzej Lewinski
Langerhans cell histiocytosis (LCH) in adults is a rare disorder of unknown etiology characterized by monoclonal proliferation of Langerhans cells. It belongs to dendritic cell disorders and occurs in 1-2 adults per million. The most common endocrine manifestation of classical LCH is associated with the posterior pituitary, with clinical symptoms of diabetes insipidus. Less than 80 reported cases of LCH involving the thyroid gland have been published so far. We present the case of a 39 years old woman with 10 years history of diabetes insipidus and secondary amenorrhoea, which appeared after second delivery...
July 2016: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/27608705/extra-pontine-myelinolysis-in-a-case-of-pan-hypopituitarism-due-to-empty-sella-syndrome
#18
Vishal Anand Gupta, Niteen Karnik, Manish Itolikar, Ketan Vekariya
Rapid correction of hyponatremia is known to cause central pontine myelinolysis (CPM). It may concurrently involve other areas of brain as well, referred as extra-pontine myelinolysis (EPM). Isolated EPM however is a very rare occurrence. We present a case of EPM where the hyponatremia was secondary to hypothyroidism due to empty sella syndrome. Chronic hyponatremia should always be corrected slowly to avoid such osmotic myelinolysis syndromes (OMS).
October 2015: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27534814/relationship-of-each-anterior-pituitary-hormone-deficiency-to-the-size-of-non-functioning-pituitary-adenoma-in-the-hospitalized-patients
#19
Kosuke Mukai, Tetsuhiro Kitamura, Daisuke Tamada, Masahiko Murata, Michio Otsuki, Iichiro Shimomura
Non-functioning pituitary adenoma (NFPA) is often associated with hypopituitarism. Diagnosis of hypopituitarism is important because of its poor prognosis and low quality of life. Among hypopituitarism, it is difficult to diagnose secondary adrenocortical insufficiency and GH deficiency without hormone stimulation test. Therefore, the aim of our study was to identify patients with NFPA who require more careful endocrinological examination. We examined the relationship between NFPA size and the prevalence of each hypopituitarism or the response of each anterior pituitary hormone by insulin tolerance test, LHRH test and TRH test...
November 30, 2016: Endocrine Journal
https://www.readbyqxmd.com/read/27495178/systemic-sarcoidosis-with-hypercalcaemia-hypothalamic-pituitary-dysfunction-and-thyroid-involvement
#20
Nassib Alsahwi, Delali Blavo, Harsha Karanchi
Sarcoidosis is a multisystem granulomatous disorder. The lungs are the principal organs affected, however, extrapulmonary involvement including disorders of the pituitary and thyroid glands has been reported but presentation with multiple endocrine manifestations is rare. We report the case of a 36-year-old African-American woman who presented with hypercalcaemia, abnormal thyroid function studies and secondary amenorrhoea. On workup including laboratory, radiological testing and biopsy she was diagnosed with sarcoidosis with multi-organ involvement...
August 5, 2016: BMJ Case Reports
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