Pituitary最新文献

{"title":"Precocious puberty, pandemic and beyond.","authors":"Guillermo F Alonso","doi":"10.1007/s11102-024-01434-8","DOIUrl":"10.1007/s11102-024-01434-8","url":null,"abstract":"<p><p>WHO declared SARS-COVID19 a pandemic in March 2020. Most governments declared health emergency states and implemented various measures. Since then, changes in the reasons for medical consultations were observed in healthcare institutions. Pediatric endocrinologists perceived an increase in the number of consultations related to early or accelerated CPP during the months following the lockdown that different governments had established. Several papers reported the increment in incidence in Central Precocious Puberty, especially in girls. Reports from different parts of the world highlighted a two to threefold rise in the number of cases of precocious puberty treated in Pediatric Endocrinology Centers. This trend of CPP incidence strongly suggests that changes in habits and the environment in which boys and girls were immersed during the lockdown, have played a significant role in triggering the early onset of the gonadotrophic axis.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"916-924"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767198","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}

{"title":"Cushing's syndrome and COVID-19.","authors":"Amina Attia, Jérôme Bertherat","doi":"10.1007/s11102-024-01466-0","DOIUrl":"10.1007/s11102-024-01466-0","url":null,"abstract":"<p><strong>Purpose: </strong>This review aims to present current data on the course of COVID-19 in patients with Cushing syndrome (CS) and discuss treatment for CS during to the pandemic.</p><p><strong>Methods: </strong>Literature review using PubMed (pubmed.ncbi.nlm.nih.gov). The search included the following terms: \"COVID19\" in combination with \"Cushing syndrome\", \"Hypercortisolism\" and \"Glucocorticoid\".</p><p><strong>Results: </strong>Chronic hypercortisolism has been reported to increase infectious risk and worsens prognostic of patients with COVID-19 potentially due to its direct impact on the immune system: lymphopenia, impairment of monocytes and neutrophils activity, diminution of complement activation. Main metabolic complications of CS - i.e. diabetes, hypertension and obesity - have been recognized as COVID-19 complications risk factors. Patients with CS treated with steroidogenesis inhibitors might experience adrenal insufficiency during COVID-19. Special attention should be paid to patients with CS and COVID-19. The pandemic has impacted - and delayed - care of chronic illnesses including CS. Specific recommendations had been provided during the pandemic: favor telemedicine consultations, limit in-hospital explorations and postpone surgery when feasible.</p><p><strong>Conclusion: </strong>There are enough evidence for an increased prevalence and severity of COVID-19 to recommend a specific attention and caution in patients with CS.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"945-954"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626678","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}

{"title":"Pituitary Apoplexy: a re-appraisal of risk factors and best management strategies in the COVID-19 era.","authors":"Andre E Boyke, Michelot Michel, Adam N Mamelak","doi":"10.1007/s11102-024-01420-0","DOIUrl":"10.1007/s11102-024-01420-0","url":null,"abstract":"<p><p>Pituitary apoplexy (PA) is a clinical syndrome caused by acute hemorrhage and/or infarction of the pituitary gland, most commonly in the setting of a pituitary macroadenoma. PA generally presents with severe headache, nausea, vomiting, visual disturbance, and, in more severe cases, altered mental status. Many factors have been attributed to the risk of developing PA, including most recently, numerous reports showcasing an association with COVID-19 infection or vaccination. Initial management of PA includes evaluation and correction of deficient hormones and electrolytes and an assessment if surgical decompression to relieve pressure on optic nerves and other brain structures is needed. While prompt recognition and treatment are crucial to avoid morbidity and mortality, in the modern era, PA is less commonly considered a true neurosurgical emergency requiring immediate (< 24 h) surgical decompression. Traditionally, surgical decompression has been the standard of care for significant mass effects. However, several studies have shown similar outcomes in visual and hormonal recovery with either surgical decompression or conservative medical management. Unfortunately, most evidence on optimal management strategies is limited to retrospective case series, small prospective studies, and one multi-center observational study. This review aims to provide the most up-to-date evidence on the role of COVID-19 in PA and best management strategies.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"898-908"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889916","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}

{"title":"Craniofacial impact of acromegaly: when muscle ma-sse-tter.","authors":"Thomas Cuny","doi":"10.1007/s11102-024-01436-6","DOIUrl":"10.1007/s11102-024-01436-6","url":null,"abstract":"","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"437-439"},"PeriodicalIF":3.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767197","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}

{"title":"Glucose metabolism outcomes after pituitary surgery in patients with acromegaly.","authors":"Eider Pascual-Corrales, Betina Biagetti, Mónica Marazuela, Diego Asensio-Wandosel, Víctor Rodríguez Berrocal, Ana Irigaray Echarri, Cristina Novo-Rodríguez, María Calatayud, Ignacio Bernabéu, Cristina Alvarez-Escola, Carmen Tenorio-Jiménez, Inmaculada González Molero, Pedro Iglesias, Concepción Blanco, Paz de Miguel, Elena López Mezquita, Cristina Lamas, Anna Aulinas, Paola Gracia, José María Recio-Córdova, Miguel Sampedro-Nuñez, Miguel Paja, María Dolores Moure Rodríguez, Carmen Fajardo-Montañana, Fernando Cordido, Edelmiro Menéndez Torre, Juan Carlos Percovich, Rogelio García-Centeno, Rosa Cámara, Felicia Alexandra Hanzu, Almudena Vicente Delgado, Laura González Fernández, Fernando Guerrero-Pérez, María Dolores Ollero García-Agulló, Iría Novoa-Testa, Rocío Villar-Taibo, Pamela Benítez Valderrama, Pablo Abellán Galiana, Eva Venegas Moreno, Fernando Vidal-Ostos De Lara, Joaquim Enseñat, Silvia Aznar, Queralt Asla, María Dolores Aviles-Pérez, Manel Puig-Domingo, Marta Araujo-Castro","doi":"10.1007/s11102-024-01415-x","DOIUrl":"10.1007/s11102-024-01415-x","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the impact of pituitary surgery on glucose metabolism and to identify predictors of remission of diabetes after pituitary surgery in patients with acromegaly.</p><p><strong>Methods: </strong>A national multicenter retrospective study of patients with acromegaly undergoing transsphenoidal surgery for the first time at 33 tertiary Spanish hospitals (ACRO-SPAIN study) was performed. Surgical remission of acromegaly was evaluated according to the 2000 and 2010 criteria.</p><p><strong>Results: </strong>A total of 604 acromegaly patients were included in the study with a total median follow up of 91 months (interquartile range [IQR] 45-163). At the acromegaly diagnosis, 23.8% of the patients had diabetes mellitus (DM) with a median glycated hemoglobin (HbA1c) of 6.9% (IQR 6.4-7.9) [51.9 mmol/mol (IQR 46.4-62.8)]. In the multivariate analysis, older age (odds ratio [OR] 1.02, 95% CI 1.00-1.05), dyslipidemia (OR 5.25, 95% CI 2.81 to 9.79), arthropathy (OR 1.39, 95% CI 2.82 to 9.79), and higher IGF-I levels (OR 1.30, 95% CI 1.05 to 1.60) were associated with a greater prevalence of DM. At the last follow-up visit after surgery, 21.1% of the DM patients (56.7% of them with surgical remission of acromegaly) experienced diabetes remission. The cure rate of DM was more common in older patients (hazard ratio [HR] 1.77, 95% CI 1.31 to 2.43), when surgical cure was achieved (HR 2.10, 95% CI 1.01 to 4.37) and when anterior pituitary function was not affected after surgery (HR 3.38, 95% CI 1.17 to 9.75).</p><p><strong>Conclusion: </strong>Glucose metabolism improved in patients with acromegaly after surgery and 21% of the diabetic patients experienced diabetes remission; being more frequent in patients of older age, and those who experienced surgical cure and those with preserved anterior pituitary function after surgery.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"497-506"},"PeriodicalIF":3.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470352","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}

{"title":"Semaglutide as a promising treatment for hypothalamic obesity: a six-month case series on four females with craniopharyngioma.","authors":"Erlend Gjersdal, Liva Bundgaard Larsen, Kåre Schmidt Ettrup, Peter Vestergaard, Eigil Husted Nielsen, Jesper Scott Karmisholt, Hermann L Müller, Jakob Dal","doi":"10.1007/s11102-024-01426-8","DOIUrl":"10.1007/s11102-024-01426-8","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with hypothalamic pathology often develop hypothalamic obesity, causing severe metabolic alterations resulting in increased morbidity and mortality. Treatments for hypothalamic obesity have not proven very effective, although the glucagon-like peptide-1 receptor agonist semaglutide has been shown to have positive effects. We examined semaglutide's effect on weight loss in a sample of patients with hypothalamic obesity.</p><p><strong>Methods: </strong>Four female patients with hypothalamic obesity resulting from treatment of craniopharyngiomas were treated with semaglutide for six months. Whole Body Dual-energy x-ray absorptiometry scans were performed, and blood samples drawn at baseline and after six months. Semaglutide dosages were increased monthly along with tracking of body weight and eating behavior (Three Factor Eating Questionnaire, TFEQ-R18).</p><p><strong>Results: </strong>BMI was reduced in all cases, with an average of 7.9 BMI (range: 6.7 to 10.1) corresponding to a weight loss of 17.0% (range: 11.3-22.4%) or 20.2 kg (range 16.2 kg to 23.4 kg). We found a comparable reduction in total fat mass (17.2%, p = 0.006) and lean mass (16.0%, p = 0.05), whereas bone mass was unchanged (2.6%, p = 0.12). All cases reported an increase in energy levels, improved mobility and physical activity. Unfavorable eating behaviors were reduced after 1 month of treatment (emotional eating - 41 points, p = 0.02, uncontrolled eating - 23 points, p = 0.11). HbA1c and total cholesterol were significantly reduced (p = 0.014 for both).</p><p><strong>Conclusion: </strong>Semaglutide is a promising and safe treatment option for HO, that improves eating behavior, reduces weight, and improves metabolic markers.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"723-730"},"PeriodicalIF":3.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11513775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860649","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}

{"title":"\"Intrasellar tumor-to-tumor metastasis: A single center experience with a systematic review\".","authors":"Guilherme Mansur, Mohammad Bilal Alsavaf, Ludovica Pasquini, Moataz D Abouammo, Chandrima Biswas, Pavnesh Kumar, Raju R Raval, Peter Kobalka, Ricardo L Carrau, Daniel M Prevedello","doi":"10.1007/s11102-024-01441-9","DOIUrl":"10.1007/s11102-024-01441-9","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigates the rare occurrence of tumor-to-tumor metastasis in Pituitary Neuroendocrine Tumors (PitNETs), also known as pituitary adenomas, aiming to enhance understanding of its diagnostic and therapeutic challenges. We report two cases from our institution of tumor-to-tumor metastasis involving PitNETs, followed by a systematic literature review.</p><p><strong>Methods: </strong>We conducted a comprehensive literature review using PubMed and Google Scholar databases. This review provides insights into patient demographics, clinical presentations, primary tumor origin, management approaches and outcomes.</p><p><strong>Results: </strong>We identified 38 documented cases of tumor-to-tumor metastasis involving the pituitary gland in the literature. This revealed a diverse range of primary tumor origins, with lung, breast, and renal carcinomas being the most prevalent. Clinical presentations varied, with visual disturbances emerging as the most frequently reported symptom. Surgical interventions predominantly resulted in subtotal resection. Kaplan-Meier survival analysis demonstrated that endoscopic endonasal approaches (EEA) are associated with longer median survival times compared to other surgical methods.</p><p><strong>Conclusion: </strong>Tumor-to-tumor metastasis to PitNETs must be considered in differential diagnoses of sellar masses. Prompt and accurate diagnosis, coupled with a multidisciplinary treatment strategy, is essential. Our study contributes to the scarce literature on such metastases, providing a foundation for further understanding of this complex pathological entity.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"455-467"},"PeriodicalIF":3.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11513765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976423","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}

{"title":"The somatotroph pituitary gland function in high-aged multimorbid hospitalized patients with IGF-I deficiency.","authors":"Olivia Tausendfreund, Martin Bidlingmaier, Sebastian Martini, Hannah Reif, Michaela Rippl, Katharina Schilbach, Ralf Schmidmaier, Michael Drey","doi":"10.1007/s11102-024-01406-y","DOIUrl":"10.1007/s11102-024-01406-y","url":null,"abstract":"<p><strong>Purpose: </strong>It is unclear whether the age-related decline in the somatotropic axis stems from a reduced growth hormone (GH) production in the pituitary gland, or from a peripheral origin akin to an acquired GH resistance. With the help of a GHRH/arginine test, high-aged multimorbid hospitalized patients with IGF-I deficiency are to be tested to determine whether there is primarily a pituitary GH deficiency in the sense of a somatopause.</p><p><strong>Methods: </strong>Seventeen multimorbid patients (eleven men and six women) with a mean age of 82 years, with IGF-I concentrations below two standard deviations of 30-year-old men and women were identified. Patients suffered from a variety of common age-related stable diseases including coronary artery disease, chronic liver or kidney disease, chronic heart failure as well as acute conditions e.g., urosepsis or endocarditis. To assess the somatotropic axis they underwent a GHRH/arginine test. Results were evaluated using descriptive statistics.</p><p><strong>Results: </strong>In average, the peak concentration of GH after stimulation was 14.8 µg/L with a range from 2.76 to 47.4 µg/L. Taking into account both, gender and BMI (with a mean of 26.5 kg/m²) for each participant, the pituitary gland was adequately stimulated in 16 out of the 17 patients. No patient reported common side effects related to the GHRH/arginine test.</p><p><strong>Conclusion: </strong>The somatotroph pituitary gland retains its secretory capacity in the advanced aged. Therefore, age does not seem to be the driving pacemaker for the functional decline of the somatotropic axis within the aged population.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"480-487"},"PeriodicalIF":3.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11513707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141180482","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}

{"title":"Headache in patients with non-functioning pituitary adenoma before and after transsphenoidal surgery - a prospective study.","authors":"Victor Hantelius, Oskar Ragnarsson, Gudmundur Johannsson, Daniel S Olsson, Sofie Jakobsson, Erik Thurin, Dan Farahmand, Thomas Skoglund, Tobias Hallen","doi":"10.1007/s11102-024-01401-3","DOIUrl":"10.1007/s11102-024-01401-3","url":null,"abstract":"<p><strong>Purpose: </strong>To study the long-term effect of transsphenoidal surgery (TSS) on headache in patients with non-functioning pituitary adenoma (NFPA) and identify factors predicting headache relief following TSS.</p><p><strong>Methods: </strong>We evaluated headache in 101 consecutive patients with NFPA who underwent TSS from September 2015 to December 2021, preoperatively and 12-months post-surgery, by using the Migraine Disability Assessment (MIDAS) questionnaire. Health-related quality of life (QoL) was assessed using the EQ-5D visual analogue scale (EQ-VAS).</p><p><strong>Results: </strong>Of 101 patients, 27 (27%) experienced disabling preoperative headache. Among these, the median total MIDAS score improved from 60 (interquartile range (IQR): 19-140) to 10 (IQR: 0-49) (P = 0.004). Additionally, headache frequency over a 90-day period decreased from 45 (IQR: 25-83) to 6 (IQR: 3-36) days (P = 0.002), and headache intensity decreased from 5 (IQR: 4-7) to 4 (IQR: 2-7) (P = 0.016) at 12-months post-surgery. At 12 months post-surgery, 18 (67%) of 27 patients with preoperatively disabling headache showed clinically relevant improvement of their headache, 4 (15%) showed deterioration, and 5 (19%) remained unchanged. In patients with clinically relevant improvement of their headache, the EQ-VAS score improved from 50 (IQR: 30 - 7) to 80 (IQR: 65-86) (P < 0.001). Of the 74 patients with no preoperative headache, 11 (15%) developed postoperative headache. We identified no clinical factors predicting postoperative headache relief.</p><p><strong>Conclusion: </strong>The study supports that clinically significant and long-lasting improvements of disabling headache and QoL can be achieved with TSS in a substantial number of patients with NFPA.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"635-643"},"PeriodicalIF":3.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11513753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066091","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}

{"title":"Efficacy and safety of pasireotide treatment in acromegaly: A systematic review and single arm meta-analysis.","authors":"Turkan Aliyeva, Juliana Muniz, Gustavo Meira Soares, Sarah Firdausa, Lubna Mirza","doi":"10.1007/s11102-024-01461-5","DOIUrl":"10.1007/s11102-024-01461-5","url":null,"abstract":"<p><strong>Background: </strong>Acromegaly is a rare chronic endocrine disorder associated with significant comorbidities. Many patients fail to achieve biochemical control with current medical therapies, including surgery and first-generation somatostatin ligands (fg-SRLs). We aimed to perform a systematic review and single-arm meta-analysis to evaluate the efficacy of the multi-receptor somatostatin ligand pasireotide in patients with active or uncontrolled acromegaly.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, and Cochrane databases for studies that assessed the efficacy of pasireotide in patients with acromegaly and reported the outcomes of (1) biochemical control and its composite indicators; (2) normalized IGF-1 level and (3) low GH level. For the statistical analysis, we used R software.</p><p><strong>Results: </strong>We included nine studies with a total of 590 patients: four clinical trials and five observational cohorts. 82.2% of the overall population consisted of inadequately controlled acromegaly patients. After a follow-up of 12 months, the pooled biochemical control rate was 26.50% (95% CI 14.87-42.66). The prevalence of normalized IGF-1 and low GH levels was 36.27% (95% CI 29.15-43.39) and 34.76% (95% CI 24.58-44.95), respectively. Additionally, biochemical response rates were sustained throughout the extension phase of these studies. In a pooled analysis including four studies with extension phase results, the prevalence of biochemical control rate was 29.03% (95% CI 11.49-46.58) with 76 events out of 281 patients. The most commonly reported adverse events were gastrointestinal disturbances in 31.26% (95% CI 7.44-72.01) and hyperglycemia in 29.55% (95% CI 21.80-37.29) of patients. The incidence of new-onset diabetes mellitus significantly increased after pasireotide treatment, with a rate of 23.36% (95% CI 19.58-27.13).</p><p><strong>Conclusion: </strong>Pasireotide demonstrates biochemical control in patients with active or uncontrolled acromegaly. Although a high rate of hyperglycemic adverse events and diabetes mellitus related to the treatment were observed, most of them were manageable.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"468-479"},"PeriodicalIF":3.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352506","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}