Guitelman M.,Sociedad Argentina de Endocrinologia y Metabolismo SAEM |
Garcia Basavilbaso N.,Sociedad Argentina de Endocrinologia y Metabolismo SAEM |
Vitale M.,Sociedad Argentina de Endocrinologia y Metabolismo SAEM |
Chervin A.,Sociedad Argentina de Endocrinologia y Metabolismo SAEM |
And 15 more authors.
Pituitary | Year: 2013
The term primary empty sella (PES) makes reference to the herniation of the subarachnoid space within the sella turcica in patients with no history of pituitary tumor, surgery or radiotherapy. To retrospectively assess clinical features, radiological findings and the biochemical endocrine function from the records of 175 patients with a diagnosis of PES. One hundred seventy-five patients (150 females) were studied. The mean age at diagnosis was 48.2 ± 14 year. Most diagnoses were made by magnetic resonance imaging (n = 172). In most patients, the pituitary function was assessed by basal pituitary hormones measurements. Pituitary scans were ordered for different reasons: headache (33.1 %), endocrine disorders (30.6 %), neurological symptoms (12.5 %), visual disturbances (8.75 %), abnormalities on sella turcica radiograph (8.75 %) and others (6.25 %). Multiple pregnancies were observed in 58.3 % of women; headaches, obesity, and hypertension were found in 59.4, 49.5, and 27.3 % of the studied population, respectively. Mild hyperprolactinemia (<50 ng/ml) was present in 11.6 % of women and 17.3 % of men. Twenty-eight percent of our patients had some degree of hypopituitarism. In the male population, hypopituitarism represented 64 % of cases, whereas it accounted for 22 % of all females. PES seems to be more commonly found in middle-aged women, with a history of multiple pregnancies. In most patients, PES was discovered as an incidental finding on imaging studies, while in almost a quarter of patients PES was found during the diagnostic evaluation of anterior pituitary deficiency, which was more common in men. © 2012 Springer Science+Business Media, LLC.
Mallea-Gil M.S.,Sociedad Argentina de Endocrinologia y Metabolismo SAEM |
Manavela M.,Sociedad Argentina de Endocrinologia y Metabolismo SAEM |
Alfieri A.E.,Sociedad Argentina de Endocrinologia y Metabolismo SAEM |
Ballarino M.C.,Sociedad Argentina de Endocrinologia y Metabolismo SAEM |
And 18 more authors.
Revista Argentina de Endocrinologia y Metabolismo | Year: 2014
Introduction: The stimulatory role of estrogens on prolactin secretionn and on proliferation of lactotropic cells is well-established. There is scarce literature about the effects of menopause in patients with prolactinomas.Objectives: To assess the evolution of tumor size and prolactin (PRL) levels in patients with microprolactinomas diagnosed and treated with dopamine agonists bromocriptine (BEC)/cabergoline (CAB) during their fertile age and the effects of discontinuation of those drugs after menopause.Material and Methods: retrospective, multicenter study. Twenty-one patients diagnosed with microprolactinomas during their fertile age were studied in their menopause. Mean ± SD age at menopause was 49±3.6 years. In all patients, treatment was stopped when they reached menopause.Results: Mean ± SD pre-treatment PRL level was 120 ± 58 ng/ml and during menopause after stopping treatment, it was 23 ± 14 ng/ml before 12 months, and 16 ± 6 ng/ml after 12 months. During menopause and when stopping treatment, the tumor disappeared in 9/21 and the tumor size decreased in 12/21 patients; a year or more after treatment discontinuation, the tumor disappeared in 9/12 and was unchanged in 3/12. The mean ± SD treatment duration was 135 ± 74 months. Two patients were restarted on treatment because PRL levels increased.Conclusions: Normal PRL levels and sustained reduction or resolution of adenomas were achieved in most patients studied. Only two out of 21 restarted treatment because of hyperprolactinemia. Dopamine agonists might be safely stopped after menopause in patients with microprolactinomas. Copyright © 2014 por la Sociedad Argentina de Endocrinología y Metabolismo.