Growth hormone deficiency problems in adult patients with pituitary adenomas
Yulduz Urmanova & Mukhlisa Shakirova
Aim of the research: To study neuroendocrine disorders at growth hormone deficiency (GHD) in adult patients with various pituitary tumours.
Materials and methods: There 27 adult patients with GHD due to different sellar region neoplasms were evaluated in 2008. Among them, there were 20 women and 7 men. Average age of patients constituted 36.3 years.
All patients evaluated with clinical, biochemical, hormonal, instrumental, roentgenologic (CT in 15 patients and MRI of pituitary in 23 patients) methods as well as evaluation of quality of life according to questionnaire (QoL).
Results: Study shown that non-functioning pituitary adenomas seen in 21 (77.7%) patients whereas prolactinoma, astrocitoma, craniopharyngioma and germinoma have seen in 2, 1, 1 and 1 patients respectively. Sixteen patients undergone transnasal surgery and 1 bifrontal surgery for pituitary tumor. Our patients revealed various neuroendocrine disorders: partial hypopituitarism in 81.5%, panhypopituitarism in 7.4%, postoperative GHD in 72.7%, postoperative panhypopituitarism in 29.6%, secondary hypocorticism in 14.8%, secondary hypogonadism in 11.1%, functional hyperprolactinemia in 11.1%, secondary amenorrhea in 29.6%, diabetes insipidus in 15%, bitemporal hemianopsia in 59.2%. Quadrant hemianopsia in 14.8% scotoma in 3.7% ptosis in 3.7% and so on.
Conclusions: 1. GHD with various sellar region neoplasms revealed in 81/5% cases (22 patients of 27 evaluated) whereas postoperative GHD have seen in all operated patients in early postoperative period 16 patients (72.7%).
2. The feature of GHD manifestation is significant decrease of psycho-emotional condition of patients along with neuroendocrine disorders.
3. Patients with GHD require biochemical evaluation, hormonal measurements, stimulating tests for GHD evaluation, quality of life evaluation, anthropometry (BMI, WV/HV), CT, MRI of pituitary, densitometry.
4. Patients with non-functioning pituitary adenomas with postoperative GHD require GH replacement therapy.