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Acute evaluation of pituitary function in patients with Crimean-Congo haemorrhagic fever
Fatih Kilicli1, Hatice S Dokmetas, İlyas Dokmetas
1Department of Endocrinology and Metabolism, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey.
Insights
Crimean-Congo haemorrhagic fever (CCHF) can lead to cortisol insufficiency, impacting pituitary function. Further research with more patients is needed to confirm these findings on CCHF's effects on the pituitary gland.
Area of Science:
- Endocrinology
- Infectious Diseases
- Neurology
Background:
- Crimean-Congo haemorrhagic fever (CCHF) is a severe hemorrhagic illness.
- Pituitary dysfunction, including hypopituitarism, can arise from pituitary ischemia and necrosis.
- Subtle clinical signs often lead to delayed diagnosis of hypopituitarism.
Purpose of the Study:
- To investigate the impact of CCHF on pituitary gland function.
- To assess hormonal levels and pituitary response in CCHF patients.
Main Methods:
- Hormone levels (free T3, free T4, TSH, GH, IGF-I, prolactin, cortisol, testosterone, estrogen) were measured in 20 CCHF patients.
- Stimulation tests (TRH, LH-RH, ACTH) were conducted.
- Pituitary MRI was performed in patients with hypocortisolism.
Main Results:
- Cortisol insufficiency was observed in 10% of CCHF patients.
- Pituitary MRI scans were normal in patients with hypocortisolism.
- No deficiencies in Growth Hormone (GH), Thyroid-Stimulating Hormone (TSH), or Follicle-Stimulating Hormone/Luteinizing Hormone (FSH/LH) were detected.
Conclusions:
- This study is the first to report on CCHF's effects on pituitary function.
- Cortisol insufficiency is a potential complication of CCHF.
- Larger studies are necessary to establish a definitive link between CCHF and pituitary dysfunction.
Context:
Crimean-Congo haemorrhagic fever (CCHF) can cause a fatal haemorrhagic syndrome. Pituitary ischaemia/infarction and necrosis are known causes of hypopituitarism, often remaining unrecognized because of subtle clinical manifestations.
Objective:
Our aim was to evaluate the effect of CCHF on pituitary function.
Subject And Methods:
Levels of serum free T3, free T4, TSH, GH, IGF-I, prolactin, cortisol, testosterone (in men) and oestrogen (in women) were studied in 20 patients who had been diagnosed with CCHF. TRH, LH-RH and 1 μg adrenocorticotropin tests were performed in all patients. The hypothalamo-pituitary region was examined by magnetic resonance imaging (MRI) in two patients who were diagnosed with hypocortisolism.
Results:
We found cortisol insufficiency in 2 (10%) of the 20 with CCHF. However, hypophyseal MRI findings were normal in these two patients. None of the patients had deficiencies of GH, TSH or FSH/LH.
Conclusion:
To our knowledge, this is the first study reporting the effect of CCHF on pituitary function. We found that cortisol insufficiency may occur in patients diagnosed with CCHF; however, studies including a larger number of patients are required to make a definite conclusion on this issue.
