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Primary "empty sella" in adults: endocrine findings
P Del Monte1, L Foppiani, C Cafferata
1Division of Endocrinology, Galliera Hospital, Genoa, Italy.
Endocrine Journal
|September 20, 2006
Summary
Primary empty sella (PES) is a heterogeneous condition with varying pituitary function. Many PES patients exhibit impaired pituitary function, ranging from hypopituitarism to growth hormone deficiency, requiring careful endocrine evaluation.
Area of Science:
- Endocrinology
- Neuroscience
Background:
- Primary empty sella (PES) is increasingly associated with pituitary dysfunction.
- Understanding the spectrum of endocrine abnormalities in PES is crucial for patient management.
Purpose of the Study:
- To analyze presenting symptoms and endocrine status in patients with primary empty sella (PES).
- To differentiate endocrine profiles in PES patients diagnosed with hypopituitarism versus those incidentally found with PES.
Main Methods:
- Retrospective analysis of 28 PES patients and 10 healthy controls.
- Assessment of pituitary and target gland hormones, including IGF-I.
- Evaluation of growth hormone (GH) response to GHRH plus arginine stimulation.
Main Results:
- PES patients diagnosed with hypopituitarism (Group 1) showed absent GH response and significantly lower IGF-I levels compared to controls.
- PES patients evaluated for other reasons (Group 2) presented with headaches/visual changes; some had mild hyperprolactinemia or hypogonadotropic hypogonadism.
- Group 2 patients exhibited blunted GH response and lower IGF-I levels compared to controls, indicating subclinical GH deficiency.
Conclusions:
- Primary empty sella (PES) presents heterogeneously, from overt hypopituitarism to isolated growth hormone deficiency.
- Comprehensive endocrine assessment, including GH stimulation testing and IGF-I measurement, is essential for PES patients.
- Careful follow-up and management are necessary for individuals with primary empty sella and associated pituitary dysfunction.
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