title: Empty sella/pituitary atrophy and endocrine impairments as a consequence of radiation and chemotherapy in long-term survivors of childhood leukemia.
abstract: Radiation-induced empty sella (ES) or pituitary atrophy/small pituitary and endocrine impairments, including pituitary and gonadal dysfunction, can manifest decades after radiation and chemotherapy in childhood-onset leukemia patients who received prophylactic cranial irradiation or total body irradiation in preparation for bone marrow transplant. Six childhood-onset leukemia patients (age at diagnosis of leukemia; 2.7-10.2 years) participated in this study. Magnetic resonance imaging (MRI) of the pituitary gland and endocrinological studies were performed 10.5-32.1 years after cranial irradiation. In four of the six patients examined, ES or pituitary atrophy was detected approximately 10.5-19.8 years after cranial irradiation. Four patients had hypogonadism (primary, 3; hypothalamic-pituitary, 1) and one had primary hypothyroidism. We conclude that ES or pituitary atrophy and endocrine impairments can manifest decades after radiation and chemotherapy in childhood-onset leukemia. These patients should, therefore, undergo regular follow-up, including pituitary MRI and hormonal examinations.
authors.affiliation: Department of Pediatrics, Hiroshima Red Cross Hospital, Hiroshima, 730-8619, Japan. ynishi@hiroshima-med.jrc.or.jp.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Nishi
authors.affiliation: Department of Pediatrics, Hiroshima Red Cross Hospital, Hiroshima, 730-8619, Japan.
authors.forename: Kazuko
authors.initials: K
authors.lastname: Hamamoto
authors.affiliation: Department of Pediatrics, Hiroshima Red Cross Hospital, Hiroshima, 730-8619, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Fujita
authors.affiliation: Department of Pediatrics, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Okada
mesh_terms: D017668:Age of Onset; D001284:Atrophy / Q000139:chemically induced / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D064420:Drug-Related Side Effects and Adverse Reactions; D004652:Empty Sella Syndrome / Q000139:chemically induced / Q000209:etiology; D004700:Endocrine System Diseases / Q000139:chemically induced / Q000209:etiology*; D005500:Follow-Up Studies; D006801:Humans; D007938:Leukemia / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D008279:Magnetic Resonance Imaging; D010900:Pituitary Diseases / Q000139:chemically induced / Q000209:etiology*; D010902:Pituitary Gland / Q000473:pathology; D011878:Radiotherapy / Q000009:adverse effects*; D017741:Survivors