Endocrine Abstracts

JOINT2165

Background: The prevalence of asymptomatic pituitary adenomas varies between 10% and 22%, while clinically relevant pituitary adenomas occur in 1 of 1000 individuals (1). The prevalence of pituitary lesions in patients with congenital adrenal hyperplasia (CAH) is unknown. Therefore, the study aims to present pituitary findings in CAH patients from a single Expert Center for Rare Endocrine Diseases.

Methods: The present retrospective study includes all patients (18-57 years old) with CAH who have been followed-up in the last 15 years. Imaging studies have reported the prevalence and characteristics of the established pituitary formations.

Results: The data of 72 CAH patients (60 women and 12 men) were studied. Ten pituitary lesions (13.9 %) were found, including one Rathke cyst (1.4%), three prolactinomas (4.2%), and six nonfunctioning adenomas (8.3%) in 8 CAH women and 2 CAH men. Additionally, three female cases of “empty sella” were revealed by imaging studies (4.2%). The main indications for MRI in CAH patients were headache, mildly or moderately increased prolactin levels, and increased ACTH levels with suspicion of reactive adenomas. All pituitary adenomas were microadenomas varying between 3 and 7.8 mm. Most pituitary microadenomas (66.7 % [6/9]) were found in women with a late CAH form. No age (27.5 vs. 28 years, P = 0.530) or ACTH differences (16.61 vs. 15.05 pmol/l, P = 0.491) were found between patients with pituitary lesions and other CAH patients;

Conclusions: Pituitary microadenomas are commonly found in female patients with a late CAH form. Further studies are needed to evaluate the prevalence of different pituitary lesions and their evolution in CAH individuals.KeywordsCAH, pituitary adenoma, prolactinoma.References1. Daly AF, Beckers A. The Epidemiology of Pituitary Adenomas. Endocrinol Metab Clin North Am. 2020;49(3):347-355.