Endocrine Abstracts

Purpose: The aim of this study was to evaluate the association and frequency of thyroid autoimmunity in patients with empty sella syndrome and to evaluate the possible effects of thyroid auto-antibodies on clinical and laboratory findings in patients with empty sella syndrome.

Materials and methods: We recruited 93 patients (female) and 22 male patients (mean age 55.51±14.82) who were admitted to the Endocrinology Clinic of Erzurum Regional Training and Research Hospital between January 2010 and December 2016. 105 healthy individuals (84.8% female) were included in the healthy, body mass index (BMI) normal values and defined as the control group. Empty sella diagnosis was based on pituitary magnetic resonance (MR) results. As a criterion of euthyroid Hashimoto Thyroiditis (HT); Patients with normal thyroid function tests, positive thyroid auto-antibodies and radiologic appearance compatible with HT were accepted as patients.

Results: There was no statistically significant difference between the two groups in terms of BMI, TSH, prolactin, ACTH, GH (P>0.05). Cortisol levels were significantly lower in the patients with empty sella syndrome than in the control group (P=0.037). Empty sella and control groups were evaluated for the association of euthyroid Hashimoto’s disease. Euthyroid HT was diagnosed in 41 (35.6%) of the empty sella group and 1 (0.95%) of the control group (P≤0.001). There was a significant positive correlation between Anti-TPO and Anti-TG and empty sella syndrome (r=0.65, P≤0.001, r=0.63, P≤0.001, respectively). There was a statistically significant positive correlation between Anti-TPO and Anti-TG, euthyroid HT, age, BMI, right thyroid volume, left thyroid volume, FT3 and FT4 (P<0.05). In ROC analysis, sensitivity for Anti-TPO≥9.5 was 94.5% and specificity 72% for empty sella. For Anti-TG ≥ 10.5, the sensitivity was 80% and the specificity was 79%. The AUC value of Anti-TPO was 87.9% (P≤0.001) and the AUC value of Anti-TG was 86.4% (P≤0.001).

Discussion: There is a positive relationship between thyroid auto-antibodies and the clinical and laboratory findings of the empty sella. As a result, it is possible that some of the idiopathic empty sella syndrome cases occur via HT. It is advisable to investigate the presence of HT in patients with empty sella syndrome. Therefore, when supported by controlled clinical trials, it will be clear that future euthyroid HT may be a risk factor for empty sella. Further work is needed.