Endocrine Abstracts

JOINT946

Background: Pituitary imaging is vital for identifying structural and functional abnormalities contributing to endocrine dysfunction in sickle cell disease (SCD). Chronic hypoxia, iron overload, and microvascular damage often lead to growth hormone (GH) deficiencies, delayed puberty, and other complications. This review explores the role of imaging in diagnosing and managing these issues.

Objectives: 1. To evaluate the diagnostic utility of imaging modalities, particularly MRI, in detecting pituitary abnormalities in SCD.

2. To investigate the relationship between structural pituitary changes and endocrine dysfunction.

3. To highlight the potential of advanced imaging biomarkers in risk stratification and monitoring.

Methods: A chronological review of studies from 1993 to 2024 was conducted, analyzing findings from MRI, CT, and advanced imaging techniques to assess their role in detecting pituitary abnormalities and associated endocrine dysfunctions in SCD patients.

Results: • Early studies identified empty sella and vascular insults linked to growth impairments (Broadbent et al., 1993; Soliman et al., 1995, 1997).

• MRI established itself as the gold standard for detecting pituitary siderosis, reduced gland size, and structural atrophy strongly associated with GH deficiency (Smiley et al., 2008; Vadivelan et al., 2024).

• Functional MRI revealed links between metabolic stress, reduced connectivity, and cognitive deficits (Fields et al., 2020). Blood-brain barrier disruptions further highlighted vascular-neuroendocrine interplay (Lin et al., 2021).

• Quantitative imaging biomarkers enhanced the understanding of hemodynamic and structural disruptions, aiding in early detection and monitoring of dysfunctions (Stotesbury et al., 2021).

• Animal models demonstrated white matter injury and astrocyte activation contributing to cognitive and motor dysfunctions, mirroring human findings (Hazra et al., 2023).

• Pituitary imaging findings such as iron deposition and structural abnormalities were directly associated with panhypopituitarism, delayed puberty, and hypothyroidism (Shekhar et al., 2021).

Conclusion: Pituitary imaging, especially MRI, is essential for diagnosing structural abnormalities and functional disruptions in SCD. Advances in biomarkers and quantitative techniques promise improved detection, monitoring, and personalized interventions to mitigate endocrine dysfunctions in SCD.

Keywords: Sickle Cell Disease, Pituitary Imaging, Endocrine Dysfunction, MRI, Growth Hormone Deficiency, Iron Overload, Biomarkers.