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[The primary empty sella syndrome. A case report study (author's transl)]

M Casini, V Bianchi, E Brocchi

    L'Ateneo Parmense. Acta Bio-Medica : Organo Della Societa Di Medicina E Scienze Naturali Di Parma
    |January 1, 1980
    PubMed
    Summary

    Empty sella syndrome, where the pituitary gland flattens, can present with obesity and hyperglycemia. A case report suggests a potential link between this condition and diabetes due to disrupted neurovascular connections.

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    Area of Science:

    • Endocrinology
    • Neuroimaging
    • Pathophysiology

    Background:

    • Empty sella syndrome involves subarachnoid space extension into the sella turcica, remodeling it and flattening the pituitary gland.
    • Enlargement of the sella turcica can mimic pituitary tumors, posing diagnostic challenges.
    • While most patients maintain normal pituitary function, approximately 30% experience hypopituitarism.

    Observation:

    • A case report details a male patient presenting with obesity and hyperglycemia.
    • Endocrine evaluations, including TRH, Gn-RH, thyroid hormone levels, Arginine, and metyrapone tests, yielded normal results.
    • Oral glucose tolerance testing (OGTT) indicated maturity-onset diabetes with a glycemia of 160 mg%.

    Findings:

    • This case highlights a rare clinical association between primary empty sella syndrome and diabetes mellitus.

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  • The endocrine function tests were normal, suggesting the diabetes is not a direct consequence of hypopituitarism.
  • The observed hyperglycemia in the context of empty sella syndrome is not well understood.
  • Implications:

    • The findings suggest a potential, though not fully understood, link between empty sella syndrome and diabetes.
    • Disruption of the normal hypothalamo-pituitary neurovascular connection is hypothesized as a possible mechanism for this association.
    • Further research is warranted to elucidate the pathophysiology of this rare clinical presentation.