Anemia in Patients With Pituitary Adenomas: Prevalence and Correlation With Hypopituitarism

Reports on the prevalence of anemia in pituitary tumors are rare. This study aimed to establish the prevalence of anemia at the time of diagnosis in a cohort of patients with acromegaly, non-secretory pituitary adenomas (NFA), and prolactinomas. A secondary objective was to evaluate the coexistence of hypopituitarism and anemia.

 Clinical and hematological data were reviewed in the medical records of patients diagnosed with pituitary adenomas at a neuroendocrinology reference center. Of the 344 cases eligible for the study, 98 (28.5%) were patients with acromegaly (mean age 50.5 years old, 57.1% women), 166 (48.3%) patients had NFA (64.6 years old, 44% women), and 80 (23.2%) had prolactinomas (52.1 years old, 60% women).

Anemia was diagnosed in 68 (19.8%) patients: 22 (32.35%) with acromegaly (average hemoglobin (aHb): 11.8 g/dL), 29 (42.65%) with NFA (aHb: 11.6) and 17 (25%) with prolactinomas (aHb: 11.5). The prevalence was significantly higher in men, with 45 cases (27%), compared to 23 (13%) cases in women (p = 0.002). Most cases had mild anemia, 65 (96.6%). Regarding the classification according to mean corpuscular volume and mean corpuscular hemoglobin concentration values, 59 (87%) had normocytic normochromic anemia. Testosterone and thyroxine deficiency did not significantly affect the frequency of anemia. Anemia was associated with hypocortisolism (p= 0.027) and growth hormone deficiency (IGF-1) in the NFA group (p= 0.009).

This study shows a high prevalence of anemia, particularly in men, among patients with pituitary adenomas. The results improve knowledge of the comorbidities in patients with pituitary adenomas and suggest the importance of monitoring blood counts in patients' evolution, given the impact of anemia on general health.