Endocrine Dysfunction and Follow-Up Outcomes in Patients With Pituitary Abscess |
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| Affiliation: | 1. From the Department of Endocrinology and Metabolism, Guangzhou General Hospital of Guangzhou Command of PLA, Guangzhou, China;2. Department of Neurosurgery, Guangzhou General Hospital of Guangzhou Command of PLA, Guangzhou, China;3. South China Medical Center for Pituitary Tumor, Guangzhou General Hospital of Guangzhou Command of PLA, Guangzhou, China;4. Department of Endocrinology, The Second People''s Hospital of Guangdong Province, Guangzhou, China.;1. Department of Neurology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe 650-0047, Japan;2. Department of Neurology, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan;3. Department of Radiology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe 650-0047, Japan;4. Emergency Department, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe 650-0047, Japan;5. Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan;1. Menzies Research Institute Tasmania, University of Tasmania, Private Bag 23, Hobart, Tasmania 7000, Australia;2. Australian Institute of Musculoskeletal Science, NorthWest Academic Centre, The University of Melbourne, Western Health, St Albans, Victoria 3021, Australia;1. From the Division of Otolaryngology-Head & Neck Surgery, University of Connecticut School of Medicine, Farmington, Connecticut;2. Department of Internal Medicine, University of Virginia Health System, Charlottesville, Virginia;3. Department of Otolaryngology-Head & Neck Surgery, Boston University Medical Center, Boston, Massachusetts;4. Section of Endocrinology, Diabetes, and Nutrition, Boston University Medical Center, Boston, Massachusetts;5. Department of General Surgery, Boston University Medical Center, Boston, Massachusetts;6. Department of General Surgery, Stamford Hospital, Stamford, Connecticut.;1. Department of Neurology, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt;2. Department of Neurophysiology, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt;1. From the Center for Adrenal Disorders, Brigham and Women''s Hospital, Harvard Medical School, Boston, Massachusetts;2. Department of Endocrinology, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates;3. Division of Endocrinology, University of Michigan Medical Center, Ann Arbor, Michigan. |
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| Abstract: | Objective: Endocrine dysfunction caused by pituitary abscess (PA) and its outcomes have not been fully studied. This study aims to investigate endocrine dysfunction and outcomes in patients with PA.Methods: Eight patients (3 males and 5 females) with PA were identified for collecting clinical, hormone, and therapeutic data before and after long-term follow-up lasting 12 to 116 months (median, 25 months) since the first hospitalization, which was regarded as the baseline time. All patients' pituitary and respective target gland functions were evaluated. Six patients had acute onset (less than 1 month), and the other 2 patients had chronic onset (more than 6 months). Five patients underwent surgical therapy, and the other 3 patients underwent conservative therapy. The factors associated with endocrine outcome were analyzed as well.Results: At baseline, the release of 91.7% (22 of 24 total) of pituitary tropic hormones was impaired, but 59.1% (13 of 22) had normalized by the last follow-up. Male gender, acute onset mode, and normal baseline prolactin level seemed to be the factors that favored tropic hormone normalization, whereas surgical operation was not. Two patients received provocative test suggesting decreased reserves of both somatotrophin and prolactin or only somatotrophin. Only 1 patient suffered from permanent diabetes insipidus.Conclusion: The production of almost all pituitary tropic hormones was impaired with PA in the present study, but production of nearly 60% percent of the hormones normalized during follow-up of >1 year. A chronic abscess state may be the most important factor associated with permanent hormone deficiency.Abbreviations: ACTH = adrenocorticotropic hormone GnH = gonadotrophin MRI = magnetic resonance imaging PA = pituitary abscess TSH = thyroid-stimulating hormone |
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