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Neuroendocrinological aspects of primary empty sella.
B Becejac1, B Vizner, M Berković
1Department of Neuroendocrinology and Pituitary Diseases, University Hospital Sestre Milosrdnice, Zagreb, Croatia.
Collegium Antropologicum
|April 5, 2003
Summary
Primary empty sella syndrome often impacts obese women, causing symptoms like headaches and visual issues. Many patients exhibit pituitary dysfunction, with a significant portion experiencing hypopituitarism.
Area of Science:
- Neuroendocrinology
- Radiology
- Internal Medicine
Background:
- Primary empty sella (PES) is a condition where the pituitary gland is flattened or absent within the sella turcica.
- PES is often diagnosed via imaging techniques like CT, cisternography, and MRI.
- Neuroendocrine evaluation is crucial for understanding the impact of PES on pituitary function.
Observation:
- This study analyzed 42 patients (33 women, 9 men) with confirmed primary empty sella.
- Headache, visual disturbances, and hypertension were prominent symptoms, particularly in obese women (84.5%).
- Dynamic endocrine testing included insulin-induced hypoglycemia and pituitary stimulation tests (GnRH, TRH).
Findings:
- A variable degree of pituitary dysfunction was observed in 66.6% of patients.
- Latent hypopituitarism affected 47.6% of patients, while 19% had manifest hypopituitarism requiring therapy.
- No evidence of endocrine dysfunction was found in 33.3% of patients; mild hyperprolactinemia was noted in 3 patients.
Implications:
- Primary empty sella frequently leads to pituitary dysfunction, necessitating comprehensive neuroendocrine assessment.
- Obesity is a significant factor associated with symptomatic primary empty sella, especially in women.
- The study highlights the importance of endocrine testing in managing patients with primary empty sella, despite the absence of diabetes insipidus or rhinoliquorrhea in this cohort.