ECE2020 ePoster Presentations Pituitary and Neuroendocrinology (94 abstracts)
Prevalence of hypocortisolism and replacement treatment after transsphenoidal surgery pituitary adenomas
Maria del Mar Roca-Rodriguez 1 , Jesús Manuel Cornejo-Domínguez 1 , Álvaro Vidal-Suárez 1 , Pedro Muriel-Cueto 2 , Irene Iglesias-Lozano 3 , Inmaculada Gavilán-Villarejo 1 & Manuel Aguilar-Diosdado 1
1Puerta del Mar, Endocrinology and Nutrition, Cádiz, Spain; 2Puerta del Mar, Pathological Anatomy, Cádiz, Spain; 3Puerta del Mar, Neurosurgery, Cádiz, Spain
Aim: Evaluation of hypocortisolism and replacement treatment after transsphenoidal surgery pituitary adenomas and subsequent follow-up in Endocrinology offices.
Material and method
We conducted a retrospective intra-subject study of patients with pituitary adenomas who were undergone surgery. Clinical and analytical data were evaluated at baseline and after surgery between 2012–2018.
Results: 30 patients (50% women) were analyzed. Mean age 48.6 ± 12.1 years, mean size of adenomas 2 ± 1.1 cm (26.7% microadenomas and 73.3% macroadenomas) and mean time after surgery 1.4 ± 0.5 months. Before surgery, we observed 16.7% hypothyroidism, 3.3% somatotrophic hormone deficiency, no cases of hypocortisolism or hypogonadism and 33% of subjects had campimetric alterations. After surgery, we detected 34.8% hypothyroidism, 27.6% somatotrophic hormone deficiency, 40% hypogonadism and 10% insipidus diabetes (in 6.7% of cases it persisted after a year). Campymetry improved by 66% (50% complete resolution, 22% unchanged and 11% worse). Regarding post-surgery basal cortisol, 23.3% < 3 mg/dl, 33.3% 3–11 mg/dl, 26.7% 11–18 mg/dl and 16.7% > 18 mg/dl. Ten percent required reevaluation (66% 1 mg ACTH test and 33% insulin hypoglycemia). Mean dose of corticosteroid replacement therapy was 25.7 ± 9.6 mg/day at hospital discharge, 16.5 ± 12/day mg at first visit after surgery and 12.6 ± 14.4 mg/day after a year.
Conclusions: We observed a significant incidence of hypogonadism after surgery. Campimetric affectation improved in most of patients. Hypocortisolism was present in 56.6% of subjects after surgery and they needed corticosteroid replacement therapy. Less than 50% of patients were treated unnecessarily. New strategies to select patients who need replacement steroid treatment are needed.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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