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Mansour AA, Alhamza AHA, Almomin AMSA, Zaboon IA, Alibrahim NTY, Hussein RN, Kadhim MB, Alidrisi HAY, Nwayyir HA, Mohammed AG, Al-Waeli DK, Hussein IH. Spectrum of Pituitary disorders: A retrospective study from Basrah, Iraq. F1000Res 2018; 7:430. [PMID: 30026929 PMCID: PMC6039954 DOI: 10.12688/f1000research.13632.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/19/2018] [Indexed: 11/21/2022] Open
Abstract
Background: Pituitary disorders spectrum includes a wide variety of diseases.This study aimed at a comprehensive description of such disorders for patients from Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC) in Basrah (Southern Iraq). Methods: Retrospective data analysis of FDEMC for the period from January 2012 through June 2017. We included all patients with pituitary disorders who have MRI pituitary. Results: The pituitary disorders were more common among women. Those with macroadenoma were older than those with microadenoma with nearly equal gender prevalence of macroadenoma. Pituitary adenoma constituted the bulk of pituitary disorders in this registry (67.2%). Growth hormone secreting adenoma were the commonest adenoma seen in 41.0% followed by clinically non-functioning pituitary adenoma(NFPA)in 31.4% and prolactinoma in 26.9%. About 64.8% of pituitary adenoma was macroadenoma. Macroadenoma was seen in 73.4 % of growth hormone secreting adenoma, 61.2% in NFPA and 62.0% of prolactinoma (of them six were giant prolactinoma) Conclusion: Pituitary adenoma constituted the bulk of pituitary disorders in Basrah, growth hormone secreting adenoma is the commonest adenoma followed by NFPA and prolactinoma due to referral bias. A change in practice of pituitary adenoma treatment is needed.
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Affiliation(s)
- Abbas Ali Mansour
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine,Hattin post office. P.O Box: 142, Basrah, 61013, Iraq
| | - Ali Hussain Ali Alhamza
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine,Hattin post office. P.O Box: 142, Basrah, 61013, Iraq
| | - Ammar Mohammed Saeed Abdullah Almomin
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine,Hattin post office. P.O Box: 142, Basrah, 61013, Iraq
| | - Ibrahim Abbood Zaboon
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine,Hattin post office. P.O Box: 142, Basrah, 61013, Iraq
| | - Nassar Taha Yaseen Alibrahim
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine,Hattin post office. P.O Box: 142, Basrah, 61013, Iraq
| | - Rudha Naser Hussein
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine,Hattin post office. P.O Box: 142, Basrah, 61013, Iraq
| | - Muayad Baheer Kadhim
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine,Hattin post office. P.O Box: 142, Basrah, 61013, Iraq
| | - Haider Ayad Yassin Alidrisi
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine,Hattin post office. P.O Box: 142, Basrah, 61013, Iraq
| | - Hussein Ali Nwayyir
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine,Hattin post office. P.O Box: 142, Basrah, 61013, Iraq
| | - Adel Gassab Mohammed
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine,Hattin post office. P.O Box: 142, Basrah, 61013, Iraq
| | - Dheyaa Kadhim Al-Waeli
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine,Hattin post office. P.O Box: 142, Basrah, 61013, Iraq
| | - Ibrahim Hani Hussein
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine,Hattin post office. P.O Box: 142, Basrah, 61013, Iraq
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Mansour AA, Alhamza AHA, Almomin AMSA, Zaboon IA, Alibrahim NTY, Hussein RN, Kadhim MB, Alidrisi HAY, Nwayyir HA, Mohammed AG, Al-Waeli DK, Hussein IH. Spectrum of Sellar and Parasellar Region Lesions: A retrospective study from Basrah, Iraq. F1000Res 2018; 7:430. [PMID: 30026929 PMCID: PMC6039954 DOI: 10.12688/f1000research.13632.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/09/2018] [Indexed: 09/27/2023] Open
Abstract
Background: Sellar and parasellar region lesions spectrum includes a wide variety of diseases. This study aimed at providing a comprehensive overview of such lesions in patients from Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC) in Basrah (Southern Iraq). Methods: Retrospective data analysis from FDEMC for the period January 2012 through June 2017. We included all patients with sellar and parasellar region lesions who received a MRI scan on their pituitary region Results: The total enrolled patients were 232 (84 men and 148 women),with age range 15-75 years.Pituitary disease and adenoma were more common among women. Those with macroadenoma were older than those with microadenoma, with nearly equal gender prevalence of macroadenoma. Pituitary adenoma constituted the bulk of pituitary disease in this setting (67.2%). Growth hormone secreting adenoma were the most common adenoma seen in 41.0%, followed by clinically non-functioning pituitary adenoma (NFPA) in 31.4% and prolactinoma in 26.9%. About 64.8% of pituitary adenoma was macroadenoma. Macroadenoma was seen in 73.4% of growth hormone secreting adenoma (acromegaly), 61.2% in NFPA and 62.0% of prolactinom a(of them six were giant prolactinoma). Conclusion: Pituitary adenoma constituted the bulk of sellar and parasellar region lesions, growth hormone secreting adenoma is the the most common adenoma followed by NFPA and prolactinoma due to referral bias. A change in practice of adenoma treatment is needed.
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Affiliation(s)
- Abbas Ali Mansour
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine,Hattin post office. P.O Box: 142, Basrah, 61013, Iraq
| | - Ali Hussain Ali Alhamza
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine,Hattin post office. P.O Box: 142, Basrah, 61013, Iraq
| | - Ammar Mohammed Saeed Abdullah Almomin
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine,Hattin post office. P.O Box: 142, Basrah, 61013, Iraq
| | - Ibrahim Abbood Zaboon
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine,Hattin post office. P.O Box: 142, Basrah, 61013, Iraq
| | - Nassar Taha Yaseen Alibrahim
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine,Hattin post office. P.O Box: 142, Basrah, 61013, Iraq
| | - Rudha Naser Hussein
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine,Hattin post office. P.O Box: 142, Basrah, 61013, Iraq
| | - Muayad Baheer Kadhim
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine,Hattin post office. P.O Box: 142, Basrah, 61013, Iraq
| | - Haider Ayad Yassin Alidrisi
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine,Hattin post office. P.O Box: 142, Basrah, 61013, Iraq
| | - Hussein Ali Nwayyir
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine,Hattin post office. P.O Box: 142, Basrah, 61013, Iraq
| | - Adel Gassab Mohammed
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine,Hattin post office. P.O Box: 142, Basrah, 61013, Iraq
| | - Dheyaa Kadhim Al-Waeli
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine,Hattin post office. P.O Box: 142, Basrah, 61013, Iraq
| | - Ibrahim Hani Hussein
- Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Diabetes, Endocrine and Metabolism Division, Department of Medicine, Basrah College of Medicine,Hattin post office. P.O Box: 142, Basrah, 61013, Iraq
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Milosević M, Stojanović M, Nesović M. Primary hypothyroidism associated with empty sella turcica and hypopituitarism. ACTA ACUST UNITED AC 2005; 58:410-3. [PMID: 16296587 DOI: 10.2298/mpns0508410m] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Introduction Empty sella syndrome is a rather frequent neuroradiological finding in the general population and can be associated with hypopituitarism. Examinations reveal low pituitary hormone levels and lack of response to stimuli. Most patients suffer from central hypothyroidism as part of pituitary insufficiency. Primary hypothyreoidism is a rare finding in these patients. Case report We present 3 patients: one female and two male, suffering from complete hypopituitarism, as part of the empty sella syndrome diagnosed due to low concentrations of all pituitary hormones, elevated TSH and low thyroid hormones. TRH, LHRH, ACTH and ITT tests, as well as IGF1 have confirmed hypopituitarism and primary hypothyroidism. CT and NMR in all three patients showed empty sella without a tumor in it. The diagnosis of primary hypothyrodism in the first patient was made before hypopituitarism has taken place, or at the same time in the second patient, whereas in the third patient it was diagnosed twenty years later. In two patients anti-TPO and anti-Tg antibody levels were high, and in the third patient they were not elevated. It can be assumed that the etiology of primary hypothyrodism in all three patients was of autoimmune origin, which caused thyroid hypofunction. High level of TSH in all three patients and especially in the patient whose hypopituitarism was diagnosed twenty years later, showed presence of thyrotrophic cells in the pituitary. Evaluation of the hypothalamic-pituitary-thyroid axis was carried out during the complete substitution therapy of hypopituitarism. Conclusion Diagnosing primary hypothyrodism associated with hypopituitarism helps improving the knowledge on empty sella syndrome and points to different clinical syndromes characterized by lack of mixoedema, although approach to therapy is the same for both primary and central hypothyroidism.
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