COVID19 感染和疫苗接种与垂体性脑瘫的风险：纠缠不清的纱线。

IF 3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Pub Date : 2024-10-21 DOI:10.1007/s12020-024-04078-7

Alberto Ragni, Emilia Biamonte, Beatrice Cavigiolo, Edoardo Luigi Maria Mollero, Giulia Bendotti, Enrico Gabellieri, Paola Leporati, Marco Gallo

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引用次数: 0

摘要

目的：越来越多的报道显示，垂体性脑瘫（PA）与感染COVID19和接种COVID19疫苗有关。我们的目的是分析已发表的病例，并比较两组病例（感染与接种）的临床特征：我们系统回顾了已发表的文献中所有与 COVID19 感染或接种疫苗相关的 PA 病例。我们还介绍了本中心处理的两例病例：结果：共分析了 43 个病例。接种 COVID19 疫苗后出现 PA 的患者（n = 7）与感染 COVID19 后出现 PA 的患者（n = 36）相比，年龄明显更小（p = 0.009），发病更突然（p = 0.022），但激素受累程度较轻（p = 0.008），随访期间垂体功能持续减退的比例较低（p = 0.001）。接种疫苗组的患者没有PA的临床风险因素，但这一差异未达到统计学意义：结论：与 COVID19 相关的 PA 虽然罕见，但具有重要的临床意义，尽管这种关联的病理生理学细节尚不清楚。鉴于临床表现明显不同，我们可以推测，与感染 COVID19 引起的 PA 相比，接种 COVID19 引起的 PA 可能是一个不同的临床实体，具有不同的病理生理机制。

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COVID19 infection and vaccination and the risk of pituitary apoplexy: an entangled yarn.

Purpose: Pituitary apoplexy (PA) has been increasingly reported in association with both infection from and vaccination for COVID19. Our aim was to analyse the available published cases and compare the clinical characteristics in the two groups (infection vs vaccination).

Methods: We systematically reviewed the published literature for all cases of PA associated with COVID19 infection or vaccination. We also presented two cases managed at our Centre.

Results: Collectively, fortythree cases were analysed. Patients with PA after COVID19 vaccination (n = 7), compared with patients with PA after COVID19 infection (n = 36), were significantly younger (p = 0.009) and had a more abrupt onset of PA (p = 0.022), but showed a milder hormonal involvement (p = 0.008) and a lower rate of persistent hypopituitarism during follow-up (p = 0.001). Patients in the vaccination group did not have clinical risk factors for PA, although this difference did not reach statistical significance.

Conclusions: PA associated with COVID19 is a rare but clinically significant entity, although pathophysiological details of this association are lacking. Given the significantly different clinical presentation, we could speculate that PA induced by COVID19 vaccination might represent a distinct clinical entity, with different pathophysiological mechanism, compared to PA from COVID19 infection.

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来源期刊

Endocrine ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

5.40%

发文量

295

审稿时长

1.5 months

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.