GnRH agonist-associated pituitary apoplexy: a case series and review of the literature

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dc.article.number102546
dc.article.number102546
dc.contributor.authorGuarda F.J.
dc.contributor.authorGuarda F.J.
dc.contributor.authorYu X.
dc.contributor.authorShiraliyeva N.
dc.contributor.authorHaines M.S.
dc.contributor.authorNachtigall L.B.
dc.contributor.authorBradbury M.
dc.contributor.authorSaylor P.J.
dc.date.accessioned2025-05-01T10:31:47Z
dc.date.available2025-05-01T10:31:47Z
dc.date.issued2021
dc.description.abstract© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.Purpose: To examine the clinical presentation and longitudinal outcome of Pituitary Apoplexy (PA) after gonadotropin-releasing hormone agonist (GnRHa) in a series of patients and compare to prior reports. Methods: A retrospective chart review was performed on seven patients receiving GnRHa who developed PA. Prior reported cases were analyzed. Results: Six men (median age 72 years) with prostate cancer and one woman (aged 22 years) undergoing oocyte donation presented with PA between 1990 and 2020. Most presented with within 24 h of the first dose, but two developed PA 1 to 5 months after GnRHa initiation. The main clinical manifestations were headache (100%), nausea and vomiting (86%). While no patients had a previously known pituitary tumor, all had imaging demonstrating sellar mass and/or hemorrhage at presentation. Among those surgically treated (5/7), 80% (4/5) of patients had pathologic specimens that stained positive for gonadotropins; the remaining patient’s pathologic specimen was necrotic. At the time of PA, the most common pituitary dysfunction was hypocortisolism. Central adrenal insufficiency and central hypothyroidism were reversible in a subset. Pituitary imaging remained stable. Conclusions: This is the first report of a case series with PA after GnRHa administration with longitudinal follow-up. Although infrequent, PA can be life-threatening and should be suspected among patients receiving GnRHa, with or without a known pituitary adenoma, who develop acute headache, nausea and/or vomiting. Since hypopituitarism was reversible in a subset, ongoing pituitary function testing may be indicated.
dc.description.funderScience Academy-BAGEP
dc.description.funderBoğaziçi University; Folio: 15B06SUP2
dc.description.funderANID FONDECYT; Folio: 1211858
dc.description.funderCONICYT-MEC; Folio: 80130064
dc.format.extent15 páginas
dc.fuente.origenScopus
dc.identifier.doi10.1007/s11102-021-01143-6
dc.identifier.eisbn978-84-9880-797-4
dc.identifier.eissn15737403
dc.identifier.isbn978-0-12-817240-7
dc.identifier.issn15737403 1386341X
dc.identifier.pubmedid33835355
dc.identifier.scieloidS0718-69242020000300109
dc.identifier.scopusidSCOPUS_ID:85104139699
dc.identifier.urihttps://doi.org/10.1007/s11102-021-01143-6
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/103796
dc.identifier.wosidWOS:000638458700001
dc.information.autorucEscuela de Medicina; Guarda Vega Francisco; 0000-0001-9104-9499; 149942
dc.issue.numero9860
dc.language.isoen
dc.nota.accesoSin adjunto
dc.pagina.final689
dc.pagina.inicio681
dc.publisherAcademic Press
dc.relation.ispartof7th Workshop On Educational Innovation In Architecture (JIDA), NOV 14-15, 2019, Madrid, SPAIN
dc.revistaPituitary
dc.rightsAcceso cerrado
dc.subjectGnRH agonists
dc.subjectHypopituitarism
dc.subjectPituitary apoplexy
dc.subjectPituitary tumors
dc.subjectProstate cancer treatment
dc.subject.ddc510
dc.subject.deweyMatemática física y químicaes_ES
dc.subject.ods02 Zero hunger
dc.subject.odspa02 Hambre cero
dc.titleGnRH agonist-associated pituitary apoplexy: a case series and review of the literature
dc.typeartículo
dc.volumen24
sipa.codpersvinculados149942
sipa.indexWOS
sipa.indexScopus
sipa.indexPubmed
sipa.trazabilidadCarga WOS-SCOPUS;01-05-2025
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