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Endocrinological Differences Between Partial and Complete Primary Empty Sella: A Comparative Analysis.

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Complete primary empty sella (PES) is linked to higher rates of adrenal insufficiency and hypogonadism. Hormonal testing is recommended for all PES patients due to potential axis dysfunction.

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Area of Science:

  • Endocrinology
  • Neuroimaging
  • Sellar Disorders

Background:

  • Primary empty sella (PES) involves cerebrospinal fluid (CSF) herniation into the sella turcica.
  • PES is classified as partial or complete based on CSF filling and pituitary gland size.
  • Limited research exists comparing hormonal abnormalities between partial and complete PES.

Purpose of the Study:

  • To investigate endocrinological differences between partial and complete primary empty sella.
  • To assess hormonal status in patients diagnosed with PES.

Main Methods:

  • Hormonal evaluation of 58 PES patients, including tests for ACTH, cortisol, TSH, fT4, FSH, LH, estradiol, testosterone, PRL, GH, and IGF-1.
  • Patients were categorized into partial and complete PES groups for comparative analysis.

Main Results:

  • Complete PES showed a significantly higher incidence of secondary adrenal insufficiency and hypogonadism.
  • Patients with complete PES had a greater proportion of multiple affected hormonal axes.
  • Secondary hypothyroidism was more prevalent in males with PES.

Conclusions:

  • Clinicians should consider secondary adrenal insufficiency and hypogonadism in patients with complete PES.
  • Universal hormonal testing is advised for all PES patients due to the high prevalence of axis dysfunction.
  • Further prospective multicenter trials are needed to confirm these findings.