Primary empty sella and GH deficiency: prevalence and clinical implications

Area of Science:

• Endocrinology
• Neuroendocrinology
• Radiology

Background:

• Primary empty sella (PES) involves herniation of cerebrospinal fluid into the sella turcica.
• The exact cause of PES is not fully understood.
• Hormonal pituitary dysfunctions, particularly involving the growth hormone (GH)/insulin-like growth factor (IGF-I) axis, have been reported in PES patients.

Purpose of the Study:

• To evaluate the GH/IGF-I axis function in adult patients with PES.
• To determine the clinical relevance of potential GH/IGF-I axis dysfunction in this population.

Main Methods:

• Studied 28 adult patients diagnosed with PES.
• Assessed basal thyroid, adrenal, and gonadal pituitary axis function.
• Performed a GH-releasing hormone (GHRH) plus arginine stimulation test for dynamic GH/IGF-I evaluation.
• Evaluated metabolic profile and bone densitometry to assess clinical significance.

Main Results:

• Growth hormone (GH) deficiency was identified in 11 patients (39.2%).
• Patients with GH/IGF-I axis dysfunction exhibited impaired metabolic profiles.
• Bone densitometry revealed deficits in patients with GH/IGF-I axis dysfunction.

Conclusions:

• Confirms the necessity of screening pituitary function, especially the GH/IGF-I axis, in patients with PES.
• GH deficiency in PES patients can have significant clinical implications.
• Highlights the importance of evaluating metabolic and bone health in PES patients with GH/IGF-I axis dysfunction.