Risk Factors, Radiological and Clinical Outcomes in Subclinical and Clinical Pituitary Apoplexy
Biagetti, Betina (Hospital Universitari Vall d'Hebron)
Sarria-Estrada, Silvana (Hospital Universitari Vall d'Hebron)
Cordero Asanza, Esteban (Hospital Universitari Vall d'Hebron)
Chaachou-Charradi, Anas (Hospital Universitari Vall d'Hebron)
Ng-Wong, Yiken Karelys (Hospital Universitari Vall d'Hebron)
Cicuendez, Marta (Hospital Universitari Vall d'Hebron)
Hernandez, Irene (Hospital Universitari Vall d'Hebron)
Rojano-Toimil, Alba (Hospital Universitari Vall d'Hebron)
Costa, Pilar (Hospital Universitari Vall d'Hebron)
Martinez-Saez, Elena (Hospital Universitari Vall d'Hebron)
Casteràs, Anna (Hospital Universitari Vall d'Hebron)
Simó Canonge, Rafael (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona

Data:	2022
Resum:	Pituitary apoplexy (PA) can be symptomatic, namely acute apoplexy (APA), or asymptomatic or subclinical (SPA). To describe the clinical characteristics and evolution of the patients with APA compared to SPA Patients and methods: Retrospective, longitudinal database analysis. We identified 58 patients with PA, and 37 accomplished the inclusion criteria (17 men, median age 47. 7 years). A total of 29 (78. 4%) had APA (17 underwent surgery, and 12 were conservatively managed), and 8 (21. 6%) had SPA. The presence of non-functioning pituitary adenoma (NFPA) odds ratio (OR): 29. 36 (95% confidence interval (CI): 1. 86-462. 36) and the largest size OR 1. 10 (95% CI: 1. 01-1. 2) elevated the risk of having surgery. Hypopituitarism developed in 35. 1% without significant differences between APA and SPA. In non-surgical patients, adenoma volume shrunk spontaneously at one year magnetic resonance imaging (MRI), without statistical differences between the conservatively treated and SPA group. APA is more frequent in larger NFPAs, and this subset of patients has a higher risk of surgery. Hypopituitarism is quite frequent even in patients with SPA, and, therefore, long-term follow-up is mandatory. In the non-surgical group, the pituitary tumour shrinkage is clinically relevant after one year of PA. Consequently, surgery indication in NFPA should be delayed and reassessed if patients remain asymptomatic.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Emergency ; Hemorrhage ; Necrosis ; Neurosurgery ; Pituitary apoplexy ; Pituitary adenoma ; Subclinical apoplexy
Publicat a:	Journal of clinical medicine, Vol. 11 (december 2022) , ISSN 2077-0383

DOI: 10.3390/jcm11247288
PMID: 36555904

13 p, 1.4 MB

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