[Pituitary apoplexy: analysis of endocrine function in 17 cases].
BACKGROUND
From a neurological standpoint, pituitary apoplexy (PA) is a well defined syndrome. There are few systematic studies addressing pituitary hormone secretion after a PA episode. The aim of the present study was to assess the frequency and degree of endocrine dysfunction due to PA.


METHODS
In 17 consecutive patients, the secretion of growth hormone (GH), the pituitary-adrenal axis status, thyrotropin (TSH), prolactin and gonadotropins (LH, FSH) were evaluated after the administration of insulin, thyrotropin releasing hormone (TRH) and gonadotropin-releasing hormone (LHRH) after an episode of PA. 20-90 days after surgery the measurements were repeated. Antidiuretic hormone (ADH) was measured by plasma/urine osmolality after water deprivation and, in some cases, by administration of hypertonic saline.


RESULTS
The most commonly found deficiency was that of GH (84%), which in two cases resulted in cure of acromegaly, followed by that of LH (78%). Pituitary-adrenal dysfunction was improved in two patients after surgery. In all cases except one there was a reduced secretion of at least two hormones. If serum prolactin was reduced, the rest of pituitary function was usually impaired. In one case, permanent diabetes insipidus developed after PA. The prevalence of PA in pituitary adenomas was 9%.


CONCLUSIONS
Pituitary hormone secretion after a PA episode is almost invariably impaired. This impairment may be reversed after surgery. Hypoprolactinemia is an indicator of pituitary hypofunction.
Fernández Real
J M
JM
Servicio de Endocrinología, Hospital de Bellvitge-Prínceps d'Espanya, Barcelona.
Villabona
C M
CM
Montaña
E
E
Acebes
J J
JJ
Ricart
W
W
Sahún
M
M
Gómez
J M
JM
Soler
J
J
D000236:Adenoma / Q000175:diagnosis / Q000601:surgery; D000328:Adult; D000368:Aged; D000818:Animals; D005260:Female; D013006:Growth Hormone / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D010899:Pituitary Apoplexy / Q000097:blood / Q000503:physiopathology* / Q000601:surgery; D010901:Pituitary Function Tests; D010902:Pituitary Gland / Q000503:physiopathology*; D010907:Pituitary Hormones / Q000097:blood; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000601:surgery; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D011388:Prolactin / Q000097:blood; D011817:Rabbits
D010907:Pituitary Hormones; D011388:Prolactin; D007986:Luteinizing Hormone; D013006:Growth Hormone
Apoplejía hipofisaria: análisis de la función endocrina en 17 casos.