Hormonal gradients between inferior petrosal sinuses in various pituitary diseases.
The aim of this retrospective study was to evaluate the existence of a multihormonal gradient between the inferior petrosal sinuses in various pituitary diseases: Cushing's disease (8 cases), acromegaly (4 cases), prolactinomas (7 cases), GH, PRL-secreting adenoma (1 case), functionless adenoma (2 cases), empty sella (3 cases) and in non-tumoral hyperprolactinemia (5 cases). A significant intersinus gradient (more than 1.4:1) was recorded for GH, ACTH and PRL in 16 patients (80%), but in only 9 patients (45%) out of the 20 with hormone-secreting tumors for TSH, FSH and LH. Moreover, of the 10 patients in the remaining groups, only in two cases was a significant intersinus gradient present: one for GH and one for LH. In conclusion, the finding of a multihormonal release in the inferior petrosal sinus ipsilateral to the adenoma is reported, for the first time, in patients with GH- and PRL-secreting adenomas. The possible explanation for such a finding may be either an increased blood flow in this site of sampling or a pituitary multihormone release through a paracrine mechanism primed by the tumoral hypersecreted hormone. In addition, the pulsatile secretory pattern and the short half-life of polypeptide hormones may contribute to better demonstrate this phenomenon in respect to glycoprotein hormones.
Merola
B
B
Cattedra di Endocrinologia, II Facoltà di Medicina, Università di Napoli, Italy.
Colao
A
A
Rossi
E
E
La Tessa
G
G
Spaziante
R
R
Lombardi
G
G
D000236:Adenoma / Q000097:blood; D000293:Adolescent; D000328:Adult; D000368:Aged; D001800:Blood Specimen Collection / Q000379:methods; D003392:Cranial Sinuses; D006728:Hormones / Q000097:blood*; D006801:Humans; D008875:Middle Aged; D010900:Pituitary Diseases / Q000097:blood*; D010911:Pituitary Neoplasms / Q000097:blood; D012189:Retrospective Studies
D006728:Hormones