Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2018) 56 P883 | DOI: 10.1530/endoabs.56.P883

1Endocrinology Department – Portuguese Institute of Oncology of Coimbra FG, EPE, Coimbra, Portugal; 2Endocrinoloy, Diabetes and Metabolism Department, Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra, Portugal; 3Faculty of Medicine, Coimbra University, Coimbra, Portugal.


Introduction: Pituitary apoplexy (PA) is an endocrine emergency and usually presents with sudden headache and visual fields changes. Pituitary function assessment should be performed promptly and repeated throughout follow-up, regardless of the choice of treatment.

Methods/design: Retrospective analysis of patients diagnosed with PA admitted to an Endocrinoloy Department of a tertiary hospital between 2002 and 2017. Review of patients’ medical records and assessement the following parameters: clinical evaluation, imaging, pituitary deficiencies and treatment at the time of the episode, two months later and by the last evaluation.

Results: We evaluated 17 patients (65% were male), mean age 55±18 years, mean follow-up time 3 years. Four patients had personal history of pituitary adenoma, two of which were non-functioning and two, ACTH-secreting. Hypertension and antiplatelet therapy were the most frequently identified risk factors. Clinical presentation included sudden headache in all patients, decreased visual acuity (38%), visual field deficit (35%) and ophthalmoparesis (43%). A pituitary adenoma was identified in 11 of the 13 patients without known pituitary disease (median diameter: 25 mm). At the time of the apoplexy, hypogonadism was detected in 11/14 patients, hypothyroidism in 9/16, adrenal insufficiency in 5/13 and growth hormone deficiency in 6/13. Twelve patients underwent surgical treatment. Histological analysis revealed gonadotroph adenoma in 4 patients, corticotroph in 2, somatotroph in 2, lactotroph in 1, null cell in 1 and necrotic findings in 2. At the time of hospital discharge, 13 patients were receiving hydrocortisone and 7 levothyroxine. Most of the operated patients had persistence of disease on imaging test after 3–6 months (7/11). At the time of the last evaluation, most patients had insufficiency of two or more pituitary axes. The most common deficits were adrenal (11/16) and gonadal (10/16). There was recovery of ophthalmologic impairment in most operated patients who initially presented with ophtalmoparesis/visual field deficits (6/7).

Conclusion: In this study, surgical treatment was the preferred therapeutic option, which allowed for recovery of visual impairment, despite little recovery of pituitary insufficiency. Patients submitted to conservative treatment had a favourable outcome. Despite being an endocrine emergency, pituitary apoplexy can have a favourable outcome if correctly identified and treated.

Volume 56

20th European Congress of Endocrinology

Barcelona, Spain
19 May 2018 - 22 May 2018

European Society of Endocrinology 

Browse other volumes

Article tools

My recent searches

No recent searches.

My recently viewed abstracts