Document Detail

Pituitary apoplexy: re-evaluation of risk factors for bleeding into pituitary adenomas and impact on outcome.
MedLine Citation:
PMID:  20926593     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess frequency, symptoms and outcome of pituitary apoplexy (PA) among pituitary adenoma patients, to gain better insight into risk factors for bleeding into pituitary adenoma and to estimate the sequelae of PA by means of a matched control group.
METHOD: By reviewing charts of 574 patients with pituitary adenoma, we analysed incidence, symptoms and outcome of PA and potential risk factors for developing PA by means of a control group (patients with pituitary adenoma without PA).
RESULTS: In total, 42 suffered from PA, all had macroadenomas; 30/217 male (14%) and 12/179 female (7%) macroadenoma patients, 32/194 patients with clinically non-functioning (16.5%) and 10/202 with clinically active (5.0%) macroadenoma were affected. Antithrombotic therapy predisposed patients to PA (P=0.026), diabetes mellitus and hypertension did not (P=1.00). Patients with PA and pituitary adenoma patients without PA had similar frequencies of hypopituitarism (45 vs 48%, P>0.05) and visual field defects (38 vs 55%, P>0.05), but ophthalmoplegia was significantly more common (76 vs 5%, P<0.001) in patients with PA. Nearly all patients were treated by surgery; most recovered from ophthalmoplegia, whereas visual function improved only moderately. Endocrine outcome was worse in patients with PA than in patients without PA.
CONCLUSIONS: Male sex and characteristics of the adenoma itself (especially tumour size and tumour type) rather than patient's cardiovascular risk factors such as diabetes and hypertension seem to predispose to PA; antithrombotic therapy may also be important.
Diane L Möller-Goede; Michael Brändle; Klara Landau; Rene L Bernays; Christoph Schmid
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Publication Detail:
Type:  Journal Article     Date:  2010-10-06
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  164     ISSN:  1479-683X     ISO Abbreviation:  Eur. J. Endocrinol.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-14     Completed Date:  2011-01-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  England    
Other Details:
Languages:  eng     Pagination:  37-43     Citation Subset:  IM    
Division of Endocrinology and Diabetes, Department of Internal Medicine, University Hospital Zurich, 8091 Zurich, Switzerland.
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MeSH Terms
Adenoma / complications*,  diagnosis*,  pathology
Case-Control Studies
Early Detection of Cancer
Incidental Findings
Medical Records
Middle Aged
Pituitary Apoplexy / diagnosis*,  etiology*,  prevention & control
Pituitary Neoplasms / complications*,  diagnosis*,  pathology
Retrospective Studies
Risk Assessment
Risk Factors
Sex Factors

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