EYES2019 7th ESE Young Endocrinologists and Scientists (EYES) Meeting Oral Presentations (67 abstracts)
Pituitary apoplexy clinical presentation and management: the experience of a single center
S Dalakoura 1 , N Kalogeris 1 , R Gyftaki 1 , E Herolidi 1 , A Dermentzoglou 1 , V Loi 1 , S Paschou 1 , K Barkas 2 & A Vryonidou 1
1Department of Endocrinology, Diabetes Mellitus and Metabolism, Athens, Greece; 2Neurosurgery Clinic General Hospital of Athens ‘Korgialenio-Benakio’, Hellenic Red Cross, Athens, Greece.
Purpose: Pituitary apoplexy is a rare endocrine emergency due to abrupt hemorrhage or infarction of a preexisting pituitary tumor. We aimed to present clinical and biochemical characteristics as well as the management of patients presented with pituitary apoplexy at our department.
Methods: Review of the records of all patients presenting with pituitary apoplexy at the Endocrinology department over the last 20 years.
Results: During the period 1998–2018, 21 patients (5 women) were hospitalized for pituitary apoplexy. The median age of patients was 56.1±12.5 years. Only one patient had known pituitary adenoma at the diagnosis of pituitary apoplexy. The majority of pituitary adenomas 18/21 (85.7%) were nonfunctioning (NFPAs). Predisposing factors were identified in 15/21 patients (71.4%). Acute and severe headache was the commonest symptom 18/21 (85.7%) followed by visual disturbances 9/21 (42.9%) and ophthalmoplegia 9/21 (42.9%). At presentation, the majority of patients 15/21 (71.4%) had one or more anterior pituitary hormone deficiencies. Twelve of 21 patients (57.1%) underwent within a week transsphenoidal surgery due to visual fields defects, ophthalmoplegia or aggressive tumor. Ophthalmoplegia was corrected in all patients. Four of the seven patients who underwent surgery had complete visual fields and 3 had improvement postoperatively while two of the patients who were treated conservatively, had also improvement of their visual fields. In 11 of 12 patients (91.6%) who had surgery, partial or total anterior pituitary hormone deficiency was remaining, as well as in eight of nine patients (88.8%) who had conservative treatment. Low prolactin levels at the onset of pituitary apoplexy did not correlate with anterior pituitary hormone deficiency in the future.
Conclusion: In patients with pituitary apoplexy transsphenoidal surgery is indicated within 7 days when visual fields defects do not improve or worsen.
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Endocrine Abstracts
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