Turkish Neurosurgery 2014 , Vol 24 , Num 3
Anterior Pituitary Hormone Deficiency in Subjects with Total and Partial Primary Empty Sella: Do All Cases Need Endocrinological Evaluation?
Sayid Shafi ZUHUR1, Idris KUZU1, Feyza Yener OZTURK1, Ender UYSAL2, Yuksel ALTUNTAS1
1Sisli Etfal Training and Research Hospital, Department of Endocrinology and Metabolism, Istanbul, Turkey
2Sisli Etfal Training and Research Hospital, Department of Radiology, Istanbul, Turkey
DOI : 10.5137/1019-5149.JTN.8671-13.0 AIM: To compare anterior pituitary functions between subjects with total and partial primary empty sella (PES) and to assess whether all cases with PES need endocrinological evaluation.

MATERIAL and METHODS: Eighty-one subjects with PES (34 total and 47 partial) were included in the study. Basal anterior pituitary and its target hormones were assessed and those with low insulin like growth factor-1 and/or low basal cortisol levels underwent insulin tolerance test (ITT).

RESULTS: 67.4% of the subjects with total and 14.9% of those with partial PES had different degrees of hypopituitarism. However, the frequency of hypopituitarism was significantly higher in cases with total PES. The odds ratio (OR) and 95% confidence interval (CI) of secondary hypothyroidism, secondary adrenal, growth hormone and gonadotropin deficiency in subjects with total compared to those with partial PES were as follows: OR = 20.0, 95% CI 4.16 – 95.9, OR = 2.4, 95% CI 1.34 – 5.7, OR = 15.3, 95% CI 4.48 – 52.6 and OR = 10.6, 95% CI 3.37 – 33.5, respectively.

CONCLUSION: A substantial number of subjects with PES, particularly those with total PES, have pituitary hormone deficiency, so regardless of the type of PES, all subjects must be promptly and carefully evaluated for anterior pituitary hormone deficiency. Keywords : Primary empty sella, Hypopituitarism, Clinical evaluation, MRI

Corresponding author : Sayid Shafi Zuhur, zuhur744@gmail.com