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Primary empty sella.

Laura De Marinis1, Stefania Bonadonna, Antonio Bianchi

  • 1Departments of Endocrinology, Catholic University of Rome, 00168 Rome, Italy.

The Journal of Clinical Endocrinology and Metabolism
|June 24, 2005
PubMed
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Primary empty sella (PES) can cause endocrine and neurological issues. Many patients experience hyperprolactinemia or hypopituitarism, requiring careful assessment and potential hormone replacement therapy.

Area of Science:

  • Neuroendocrinology
  • Radiology
  • Internal Medicine

Background:

  • Primary empty sella (PES) is a condition where the sella turcica is filled with cerebrospinal fluid.
  • It can be associated with various endocrine and neurological disturbances.

Purpose of the Study:

  • To retrospectively analyze patients diagnosed with empty sella between 1985 and 2002.
  • To investigate the prevalence of endocrine abnormalities and clinical conditions associated with PES.

Main Methods:

  • Retrospective review of 213 patients (171 female, 42 male) diagnosed with empty sella.
  • Sellar imaging (CT/MRI), neurological, ophthalmological, and endocrine evaluations were performed.
  • Hormone stimulation tests were used to diagnose hypopituitarism.

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Main Results:

  • 40 out of 213 patients (18.8%) had documented endocrine abnormalities.
  • Hyperprolactinemia was observed in 10.3% of patients, hypopituitarism in 4.2%, and isolated GH deficiency in 3.8%.
  • 138 patients had partial empty sella, and 75 had total PES.

Conclusions:

  • PES can present with a spectrum of clinical conditions, from mild endocrine issues to severe intracranial hypertension.
  • Management should include assessing the need for hyperprolactinemia treatment and hormone replacement therapy.
  • Symptomatic intracranial hypertension may necessitate cerebrospinal fluid shunting.