Pituitary最新文献_第10页

Growth hormone and bone: a basic perspective. 生长激素与骨骼：基本观点。

IF 3.3 2区医学

Pituitary Pub Date : 2024-12-01 Epub Date: 2024-10-30 DOI: 10.1007/s11102-024-01464-2

Simona Bolamperti, Isabella Villa, Luigi di Filippo

引用次数: 0

Pituitary and COVID-19 vaccination: a systematic review. 脑垂体与 COVID-19 疫苗接种：系统综述。

IF 3.3 2区医学

Pituitary Pub Date : 2024-12-01 Epub Date: 2024-05-18 DOI: 10.1007/s11102-024-01402-2

Martina Verrienti, Valentino Marino Picciola, Maria Rosaria Ambrosio, Maria Chiara Zatelli

{"title":"Pituitary and COVID-19 vaccination: a systematic review.","authors":"Martina Verrienti, Valentino Marino Picciola, Maria Rosaria Ambrosio, Maria Chiara Zatelli","doi":"10.1007/s11102-024-01402-2","DOIUrl":"10.1007/s11102-024-01402-2","url":null,"abstract":"Purpose: This systematic review aims to examine the latest research findings and assess the impact of COVID-19 vaccination on the pituitary gland.Method: PubMed and Tripdatabase were searched from January 1st, 2020 to February 12th, 2024. Case reports, case series and reviews related to post COVID-19 vaccination pituitary disease were included. Eligible articles were tabulated and analysed in the attempt to provide an overview on the epidemiology, clinical presentation, imaging, treatment, outcomes and pathophysiological background of post COVID-19 vaccination pituitary disease.Results: Among the 23 case reports included in this review, post COVID-19 vaccination hypophysitis was reported in 9 patients, pituitary apoplexy (PA) in 6 cases, SIADH in 5 cases and Isolated ACTH deficiency in 2 cases. Additionally, precipitating adrenal crisis was registered in 7 patients and pituitary tumor enlargement in 1 patient after receiving COVID-19 vaccination.Conclusion: Despite the rarity of these events, our research findings suggest an association between COVID-19 vaccination and the subsequent development of pituitary diseases. The most common manifestations include hypophysitis with ADH deficiency, PA and SIADH, with symptoms typically emerging shortly after vaccine administration. Potential pathogenetic mechanisms include molecular mimicry, vaccine adjuvants and vaccine-induced thrombotic thrombocytopenia (VITT), with the presence of ACE2 receptors in the hypothalamus-pituitary system contributing to the process. These findings can aid in diagnostic and treatment decisions for patients presenting with these syndromes. Nevertheless, given the rarity of these events, safety and efficacy of the currently available COVID-19 vaccines remain robust and we strongly advocate continuing pursuing vaccination efforts.","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"970-985"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140956848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Syndrome of inappropriate antidiuresis/hyponatremia in COVID-19. COVID-19 中的不当抗利尿/高钠血症综合征。

IF 3.3 2区医学

Pituitary Pub Date : 2024-12-01 Epub Date: 2024-08-28 DOI: 10.1007/s11102-024-01446-4

Alessandro Peri, Laura Naldi, Dario Norello, Benedetta Fibbi

{"title":"Syndrome of inappropriate antidiuresis/hyponatremia in COVID-19.","authors":"Alessandro Peri, Laura Naldi, Dario Norello, Benedetta Fibbi","doi":"10.1007/s11102-024-01446-4","DOIUrl":"10.1007/s11102-024-01446-4","url":null,"abstract":"Hyponatremia is the most frequent electrolyte alteration among hospitalized patients and it has been reported in 20-40% of patients with SARS-CoV-2 (COVID-19) infection. Multiple causes of hyponatremia have been hypothesized in these patients. The syndrome of inappropriate antidiuresis (SIAD) has been considered one of the main reasons leading to hyponatremia in this condition. SIAD can be secondary to cytokines release, in particular IL-6. Positive pressure ventilation can be another cause of hyponatremia due to SIAD. Other possible etiologies of hyponatremia in COVID-19 patients can be related to secondary hypocortisolism, nausea, vomiting, heart and kidney damage. Similar to many other clinical conditions, there is strong evidence that hyponatremia is associated with a worse prognosis also in patients with COVID-19 infection. In particular, hyponatremia has been identified as an independent risk of ICU transfer, need of non-invasive ventilation and death. Hyponatremia in COVID-19 patients is in principle acute and symptomatic and should be treated as such, according to the published guidelines. Therefore, patients should be initially treated with i.v. hypertonic saline (3% NaCl) infusion and serum [Na+] should be frequently monitored, in order to remain within a safe rate of correction. There is evidence showing that serum [Na+] correction is associated with a better outcome in different pathologies, including COVID-19 infection.","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"889-897"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Novel approach to bone comorbidity in resistant acromegaly. 抗药性肢端肥大症骨合并症的新方法。

IF 3.3 2区医学

Pituitary Pub Date : 2024-12-01 Epub Date: 2024-11-21 DOI: 10.1007/s11102-024-01468-y

Stefano Frara, Matteo Acanfora, Vincenzo Franzese, Maria Luisa Brandi, Marco Losa, Andrea Giustina

{"title":"Novel approach to bone comorbidity in resistant acromegaly.","authors":"Stefano Frara, Matteo Acanfora, Vincenzo Franzese, Maria Luisa Brandi, Marco Losa, Andrea Giustina","doi":"10.1007/s11102-024-01468-y","DOIUrl":"10.1007/s11102-024-01468-y","url":null,"abstract":"Active acromegaly may lead to irreversible complications. Among them, acromegaly osteopathy and fragility (vertebral and hip) fractures have emerged as frequent and precocious events in the natural history of the disease, being correlated with longer disease duration and higher growth hormone (GH) levels, accounting for patients' reported poor quality of life, physical performance and other life-impacting complications. Differently from primary osteoporosis, bone mineral density is not a reliable tool to predict fracture risk in this clinical setting, as patients with active disease frequently have normal or slightly reduced bone mass; whereas bone quality is particularly compromised, as determined by low trabecular bone score (TBS) in patients with active disease as compared to healthy controls or patients with cured/controlled disease. The evidence of impaired bone microstructure has been profoundly investigated with different computed tomography (CT) techniques, reporting low trabecular number and thickness as well as wide but more porous cortical bone, providing an explanation for such a high prevalence of vertebral fractures (up to 40-50% in selected cohorts). Since data on bone-active drugs are scanty, disease control remains a cornerstone to prevent fractures. Nonetheless, some potential protective effects may derive from vitamin D supplementation and pasireotide therapies, independently from disease status. Aim of this manuscript is to review the current and emerging evidence on skeletal fragility in patients with active and resistant acromegaly.","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"813-823"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Modern approach to bone comorbidity in prolactinoma. 泌乳素瘤骨合并症的现代治疗方法。

IF 3.3 2区医学

Pituitary Pub Date : 2024-12-01 Epub Date: 2024-11-14 DOI: 10.1007/s11102-024-01469-x

Meliha Melin Uygur, Sara Menotti, Simona Santoro, Andrea Giustina

{"title":"Modern approach to bone comorbidity in prolactinoma.","authors":"Meliha Melin Uygur, Sara Menotti, Simona Santoro, Andrea Giustina","doi":"10.1007/s11102-024-01469-x","DOIUrl":"10.1007/s11102-024-01469-x","url":null,"abstract":"Prolactinomas account for more than half of pituitary adenomas, and besides their clinical impact on fertility and gonadal function, they lead to detrimental effects on bone. Patients with prolactinoma are prone to deterioration of bone structure caused not only by prolactin (PRL) induced hypogonadism but also by its direct actions on bone cells and calcium metabolism. However, clinical studies have shown inconsistent evidence regarding whether PRL could have a deleterious effect independently from gonadal insufficiency on skeletal integrity. Seminal studies from our group reported an increased prevalence of vertebral fractures (VFs) in both female and male patients with prolactinoma. Treatment of prolactinoma with dopamine agonists can restore gonadal function and improve bone mineral density. Since the presence of VFs may be related to more aggressive disease, bone comorbidities in prolactinoma should be managed by a multidisciplinary team in line with the recent concept of 'pituitary tumors centers of excellence'. The review aims to evaluate the mechanism of PRL actions on bone, as well as to provide practical indications for a modern approach to the management of skeletal complications of patients with prolactin-secreting adenoma considering different clinical characteristics and outcomes.","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"802-812"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

SARS-CoV-2 infection and vaccination in patients with pituitary diseases: the experience of a Brazilian reference center. 脑垂体疾病患者的 SARS-CoV-2 感染和疫苗接种：巴西一家参考中心的经验。

IF 3.3 2区医学

Pituitary Pub Date : 2024-12-01 Epub Date: 2024-09-09 DOI: 10.1007/s11102-024-01456-2

Marcela Cunha da Silva, Solena Ziemer Kusma Fidalski, Cesar Luiz Boguszewski

{"title":"SARS-CoV-2 infection and vaccination in patients with pituitary diseases: the experience of a Brazilian reference center.","authors":"Marcela Cunha da Silva, Solena Ziemer Kusma Fidalski, Cesar Luiz Boguszewski","doi":"10.1007/s11102-024-01456-2","DOIUrl":"10.1007/s11102-024-01456-2","url":null,"abstract":"Purpose: To evaluate the prevalence and characteristics of SARS-CoV-2 infection, and the prevalence, efficacy, and safety of anti-SARS-CoV-2 vaccination in patients with pituitary diseases.Methods: Observational, cross-sectional study of adult patients with pituitary diseases followed in a reference center. Clinical data were collected and a questionnaire about SARS-CoV-2 infection, vaccination and its possible adverse effects was applied. COVID-19 disease severity was defined as mild, moderate, and severe according to the WHO classification.Results: 145 patients were studied (79 women; age 50 ± 15.8 years; duration of pituitary disease 16.8 ± 11.5 years), the cause of pituitary disease was tumoral in 74.5%, and 45.9% were on glucocorticoid replacement due to ACTH deficiency. SARS-CoV-2 infection was confirmed in 51 patients (35.2%; 32 women; age 53.8 ± 14.8 years, 22 before vaccination), with 28 (54.9%), 17 (33.3%) and 6 (11.8%) cases of mild, moderate, and severe disease, respectively, and hospitalization was indicated in 7 (14%) cases. One mild case presented pituitary apoplexy after SARS-CoV-2 infection. Advanced age was a risk factor for COVID-19. Patients with moderate and severe forms of COVID-19 had higher prevalence of dyslipidemia and duration of pituitary disease. All but one of the participants were vaccinated against COVID-19, and 60.4% had adverse events, the most common local pain (54.0%), fever (33.3%), and headache (18.4%), with one case of alopecia and two of persistent fatigue.Conclusion: The prevalence of SARS-CoV-2 infection in our cohort was 35.2%, including 14% of moderate and severe cases requiring hospitalization. The vaccination was universal and safe.","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"992-999"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Skeletal fragility in pituitary disease: how can we predict fracture risk? 垂体疾病的骨骼脆性：如何预测骨折风险？

IF 3.3 2区医学

Pituitary Pub Date : 2024-12-01 Epub Date: 2024-09-06 DOI: 10.1007/s11102-024-01447-3

Fabio Bioletto, Alessandro Maria Berton, Marco Barale, Luigi Simone Aversa, Lorenzo Sauro, Michela Presti, Francesca Mocellini, Noemi Sagone, Ezio Ghigo, Massimo Procopio, Silvia Grottoli

{"title":"Skeletal fragility in pituitary disease: how can we predict fracture risk?","authors":"Fabio Bioletto, Alessandro Maria Berton, Marco Barale, Luigi Simone Aversa, Lorenzo Sauro, Michela Presti, Francesca Mocellini, Noemi Sagone, Ezio Ghigo, Massimo Procopio, Silvia Grottoli","doi":"10.1007/s11102-024-01447-3","DOIUrl":"10.1007/s11102-024-01447-3","url":null,"abstract":"Pituitary hormones play a crucial role in regulating skeletal physiology, and skeletal fragility is a frequent complication of pituitary diseases. The ability to predict the risk of fracture events is crucial for guiding therapeutic decisions; however, in patients with pituitary diseases, fracture risk estimation is particularly challenging. Compared to primary osteoporosis, the evaluation of bone mineral density by dual X-ray absorptiometry is much less informative about fracture risk. Moreover, the reliability of standard fracture risk calculators does not have strong validations in this setting. Morphometric vertebral assessment is currently the cornerstone in the assessment of skeletal fragility in patients with pituitary diseases, as prevalent fractures remain the strongest predictor of future fracture events. In recent years, new tools for evaluating bone quality have shown promising results in assessing bone impairment in patients with pituitary diseases, but most available data are cross-sectional, and evidence regarding the prediction of incident fractures is still scarce. Of note, apart from measures of bone density and bone quality, the estimation of fracture risk in the context of pituitary hyperfunction or hypofunction cannot ignore the evaluation of factors related to the underlying disease, such as its severity and duration, as well as the specific therapies implemented for its treatment. Aim of this review is to provide an up-to-date overview of all major evidence regarding fracture risk prediction in patients with pituitary disease, highlighting the need for a tailored approach that critically integrates all clinical, biochemical, and instrumental data according to the specificities of each disease.","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"789-801"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hypopituitarism and bone disease: pathophysiology, diagnosis and treatment outcomes. 垂体功能减退症和骨病：病理生理学、诊断和治疗效果。

IF 3.3 2区医学

Pituitary Pub Date : 2024-12-01 Epub Date: 2024-05-06 DOI: 10.1007/s11102-024-01391-2

Amit Akirov, Yaron Rudman, Maria Fleseriu

引用次数: 0

Impact of medical therapy for hormone-secreting Pituitary tumors on bone. 激素分泌型垂体瘤的药物治疗对骨骼的影响。

IF 3.3 2区医学

Pituitary Pub Date : 2024-12-01 Epub Date: 2024-07-05 DOI: 10.1007/s11102-024-01421-z

Pamela U Freda

{"title":"Impact of medical therapy for hormone-secreting Pituitary tumors on bone.","authors":"Pamela U Freda","doi":"10.1007/s11102-024-01421-z","DOIUrl":"10.1007/s11102-024-01421-z","url":null,"abstract":"Purpose: Bone health is often impaired in patients with hormone-secreting pituitary tumors. Since medical therapy is central to their care, understanding how its use impacts on this is highly important.Methods: This review summarizes a systemmatic review of the literature on the effects of medical therapies for hormone-secreting pituitary tumors on bone.Results: In acromegaly, medical therapy lowers bone turnover marker (BTM) levels, consistent with correction of the high bone turnover of active disease, and overall, areal bone mineral density (aBMD) does not change or increases. Somatostatin-receptor ligand (SRL) and pegvisomant-treated acromegaly patients have persistently reduced volumetric BMD and microarchitectural abnormalities of the peripheral skeleton, deficits that are similar to those in surgically-treated patients. Fracture risk remains elevated in medically-treated acromegaly patients but in conjunction with biochemical control the risk is lessened. Treatment of prolactin-secreting tumors with dopamine agonists is associated with improvements in aBMD, but this does not always fully normalize despite effective medical treatment of the prolactinoma. In one cross-sectional study, prolactinoma patients had lower total volumetric BMD and impaired microarchitecture suggesting that bone microstructure does not fully normalize despite dopamine agonist therapy. Cross-sectional studies show a high rate of VF in patients with prolactin-secreting tumors that is lowered on cabergoline therapy, but still the fracture rate of men and postmenopausal women is higher than that of controls in some studies. Studies on the effects of modern-day medical therapy for Cushing's disease on bone are lacking.Conclusion: More research is needed on the effectsof medical therapies for hormone secreting pituitary tumors on bone health.","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"860-873"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pituitary surgery and COVID. 脑垂体手术和 COVID。

IF 3.3 2区医学

Pituitary Pub Date : 2024-12-01 Epub Date: 2024-07-05 DOI: 10.1007/s11102-024-01423-x

Ameen Farsakh, Sandra Li, Fidel Toomey, Mendel Castle-Kirszbaum, Jeremy Kam, Tony Goldschlager

引用次数: 0