Endocrine Abstracts

Aim: Empty sella is usually an incidental finding. 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. The aim of this study was to evaluate hormonal abnormalities associated with empty sella.

Materials and methods: Twenty-three primary empty sella patient were retrospectively analyzed. Hormonal evaluation including free thyroid hormones, TSH, GH, IGF1, FSH, LH, cortisol and prolactin was done.

Results: A total of 23 patients diagnosed clinically and biochemically of hormonal abnormalities were found to have empty sella on magnetic resonance imaging. Of the 23 patients, 11 were male (47.8%) and 12 (52.2%) were female. Mean age was 42.22±17.71 years. Mean age of women was 45.42±15.25, while men had 38.73±20.21 mean age. No statistically significant difference was observed between the two groups (P>0.05). Ten patients (43.5%) were euthyroid while 13 patients (56.5%) were hypothyroid. Eight patients (34.8%) were detected hypocortisolemic while 15 patients (65.2%) had normal cortisol levels. Hypogonadism were detected in 16 patients (70%). Hypoprolactinemia was detected in 10.5% in patient, hyperprolactinemia in 26.3% and normal prolactin levels were detected in 63.2% of patients. IGF1 levels were normal in 50% patient. There was negative correlation between age and free T₃ (P=0.021; r=−526).

Conclusions: Symptoms related to endocrine dysfunction is rare in adult patients developed empty sella. The most prominent features are secondary amenorrhea, loss of libido and symptoms due to the loss of pituitary reserve. In our patients; hypogonadism is the most common hormone deficiency and hypothyroidism and hypocortisolism followed that. Hypothyroidism is increasing as age increases. Care should be taken in this regard.