BES2003 Poster Presentations Comparative (4 abstracts)
Sheehan's syndrome and non-functioning pituitary adenoma - a comparison of clinical characteristics and response to growth hormone replacement
MI Goth 1 , C Auernhammer 2 , R Colak 3 , JM Gomez 4 , S Molvalilar 5 & F Kelestimur 6
1National Medical Center, Budapest, Hungary; 2University of Munich, Munich, Germany; 3Firat University Medical School, Elazig, Turkey; 4Ciutat Sanitaria Universitaria Bellvitge, Barcelona, Spain; 5Istanbul University Faculty of Medicine, Istanbul, Turkey; 6Erciyes University Medical School, Kayseri, Turkey.
Sheehan's syndrome occurs as a result of ischemic pituitary necrosis due to severe postpartum haemorrhage. It is characterized by varying degrees of anterior pituitary dysfunction and GH is one of the earliest hormones lost. We have compared patients with Sheehan's syndrome (n=189) and with non-functioning pituitary adenoma (NFPA; n=117) to determine whether adult GH deficient patients with Sheehan's syndrome have different baseline characteristics and whether they respond in a different manner to GH treatment. All patients are included in KIMS (Pharmacia International Metabolic Database).In Sheehan'syndrome hypopituitarism occurred at an earlier age (33 vs 42 yr) and the patients were more GH (stimulated GH peak 0.4 vs 0.6 ng/ml; p less than 0.05) and IGF-I (-2.63 vs -0.96 SDS; p less than 0.001) deficient. Additional anterior pituitary hormone deficiencies were more common in the patients with Sheehan's syndrome (90% vs 66%), but ADH deficiency was more common in untreated NFPA (29 % vs 4%). Increases in dual energy x-ray absorptiometry determined body lean mass were greater in Sheehan's syndrome (2.35 vs 0.5 kg; p less than 0.05) after one year of GH treatment. On the other hand, increases in BMI (0.9 vs 0.3 kg per square metre), body weight (2.4 vs 0.8 kg) and bioeletrical impedance determined body fat mass (1.5 vs 0 kg) were more significant in the patients with Sheehan's syndrome (p less than 0.05). Our data demonstrate that Sheehan's syndrome is characterized by more severe GH deficiency and the GH treatment has a different effect on body composition compared to NFPA patients.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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