Frequency of neuroendocrinal disturbances in patients with different pituitary adenomas
Mukhlisa Shakirova & Yulduz Urmanova
Study objective: To study the frequency of neuroendocrinal disturbances in patients with different pituitary adenomas.
Material and methods: Under our observation there were 53 patients with various pituitary adenomas, of them female 31, male 22, middle age of 41.5 years. According to the aetiology of the underlying disease patients were sorted out as follows: 39 patients had an inactive pituitary adenoma, 2 craniofaringeoma, 3 Cushings disease, 25 prolactinoma, 1 astrocytoma, 1 meningioma, 1 germinoma.
All patients underwent a complex of examinations including basic clinical, biochemical, radio immune hormonal (GH, IGF1, prolactinum, LH, FSH, TSH, ACTH, hydrocortisone, etc.), ophthalmologic (eyeground, vision fields) and X-ray examination (CT, MRI of sella turcica), and also a questionnaire survey of GH deficiency (GHD) in adults (QoL). The control group consisted of 20 healthy subjects of corresponding age.
Results: According to our data, in the 53 patients the following neuroendocrinal disturbances were observed: secondary amenorrhea in 13 (25%) patients, primary infertility in 5 (10%), galactorrhea in 1 (2.5%), secondary hypogonadism in 6 (12.5%), secondary hypocorticoidism in 6 (12.5%), functional hyperprolactinemia in 6 (12.5%), diabetes insipidus in 1 (2.5%), GH deficiency in 39 (73.5%), hypopituitarism in 12 (22.6%), panhypopituitarism in 2 (3.7%), secondary hypothyrosis in 6 (12.5%) patients. The prevailing majority of patients had visual disturbances: bitemporal hemianopsia 41 (79.1%) patients, amaurosis unilateral 4 (8.3%), 8 quadrant unilateral hemianopsia (16.6%), concentric narrowing of visual fields 22 (41.6%), partial atrophy of optic nerves 15 (29.1%), paracentral absolute scotoma 4 (8.3%) patients.
GHD in adults questionnaire (QoL) data analysis has shown that in our patients a reliable significant depression of a psycho-emotional status took place in 39 cases with GHD (73.5%).
Conclusions: i) The most frequent disturbance in patients with pituitary adenomas was the bitemporal hemianopsia 41 (79.1%) and GHD in 39 patients (73.5%). ii) A feature of clinical manifestations of GHD in adults is a significant depression of a psycho-emotional status of patients against the background of neuroendocrinal disturbances that is supported by the data of the special questionnaire (QoL) for adults with GHD in all 39 patients (73.5%).