Pituitary function in patients with primary and secondary empty sella

Area of Science:

• Endocrinology
• Neuroradiology
• Clinical Medicine

Background:

• Incidental findings of empty sella (ES) are increasing due to advances in neuroradiological imaging.
• The clinical significance of incidental empty sella findings remains unclear.
• This study investigates the clinical relevance and hormonal consequences of empty sella.

Purpose of the Study:

• To evaluate the incidence and clinical relevance of hormone deficiencies in patients with newly diagnosed primary or secondary empty sella.
• To determine the risk of developing hypopituitarism in patients with intact pituitary function at diagnosis.
• To assess the need for routine follow-up in empty sella patients.

Main Methods:

• A longitudinal, single-center study analyzed patients with first-time diagnosed primary or secondary empty sella.
• Patients were followed up for five years.
• Hormone deficiencies were diagnosed via basal hormone levels and dynamic stimulation tests.

Main Results:

• 119 patients (97 primary ES, 22 secondary ES) were included.
• At baseline, 34% of primary ES and 63.6% of secondary ES patients had pituitary insufficiency.
• Hypogonadism was most common in primary ES (25.8%), while adrenal insufficiency was most frequent in secondary ES (54.5%).

Conclusions:

• Hormone deficiency is prevalent in empty sella, with secondary ES and male patients at higher risk.
• The risk of developing hypopituitarism in patients with initially normal pituitary function is low.
• Routine follow-up assessments for empty sella patients with intact pituitary function are not justified.