Risk Factors, Radiological and Clinical Outcomes in Subclinical and Clinical Pituitary Apoplexy

Pituitary apoplexy (PA) can be symptomatic, namely acute apoplexy (APA), or asymptomatic or subclinical (SPA). To describe the clinical characteristics and evolution of the patients with APA compared to SPA Patients and methods: Retrospective, longitudinal database analysis. We identified 58 patient...

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Detalles Bibliográficos
Autores: Biagetti, Betina|||0000-0002-8837-4343, Sarria Estrada, Silvana|||0000-0003-0083-362X, Cordero Asanza, Esteban|||0000-0003-0464-3014, Chaachou-Charradi, Anas|||0000-0002-9085-5314, Ng-Wong, Yiken Karelys|||0000-0001-8740-3694, Cicuendez, Marta|||0000-0002-2603-9072, Hernandez, Irene, Rojano-Toimil, Alba|||0000-0002-2446-1827, Costa, Pilar, Martinez-Saez, Elena|||0000-0001-6004-5364, Casteràs, Anna|||0000-0003-4719-065X, Simó Canonge, Rafael|||0000-0003-0475-3096
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:281719
Acceso en línea:https://ddd.uab.cat/record/281719
https://dx.doi.org/urn:doi:10.3390/jcm11247288
Access Level:acceso abierto
Palabra clave:Emergency
Hemorrhage
Necrosis
Neurosurgery
Pituitary apoplexy
Pituitary adenoma
Subclinical apoplexy
Descripción
Sumario:Pituitary apoplexy (PA) can be symptomatic, namely acute apoplexy (APA), or asymptomatic or subclinical (SPA). To describe the clinical characteristics and evolution of the patients with APA compared to SPA Patients and methods: Retrospective, longitudinal database analysis. We identified 58 patients with PA, and 37 accomplished the inclusion criteria (17 men, median age 47.7 years). A total of 29 (78.4%) had APA (17 underwent surgery, and 12 were conservatively managed), and 8 (21.6%) had SPA. The presence of non-functioning pituitary adenoma (NFPA) odds ratio (OR): 29.36 (95% confidence interval (CI): 1.86-462.36) and the largest size OR 1.10 (95% CI: 1.01-1.2) elevated the risk of having surgery. Hypopituitarism developed in 35.1% without significant differences between APA and SPA. In non-surgical patients, adenoma volume shrunk spontaneously at one year magnetic resonance imaging (MRI), without statistical differences between the conservatively treated and SPA group. APA is more frequent in larger NFPAs, and this subset of patients has a higher risk of surgery. Hypopituitarism is quite frequent even in patients with SPA, and, therefore, long-term follow-up is mandatory. In the non-surgical group, the pituitary tumour shrinkage is clinically relevant after one year of PA. Consequently, surgery indication in NFPA should be delayed and reassessed if patients remain asymptomatic.

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