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2 results

  • Pituitary Dysfunction in Idiopathic Intracranial Hypertension: An Analysis of 80 Patients

  • Nandita Prabhat, Kirandeep Kaur, Aastha Takkar, Chirag Ahuja, Deeksha Katoch, Manoj Goyal, Pinaki Dutta, Anil Bhansali, Vivek Lal
  • Journal:
    Canadian Journal of Neurological Sciences / Volume 51 / Issue 2 / March 2024
    Published online by Cambridge University Press:
    04 April 2023, pp. 265-271
    • Article
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  • Background:

    Empty sella is a commonly described imaging entity in patients with idiopathic intracranial hypertension (IIH). Though menstrual and hormonal disturbances have been associated with IIH, available literature lacks systematic analysis of pituitary hormonal disturbances in IIH. More so, the contribution of empty sella in causing pituitary hormonal abnormalities in patients of IIH has not been described. We carried out this study to systematically assess the pituitary hormonal abnormalities in patients with IIH and its relation to empty sella.

    Methods:

    Eighty treatment naïve patients of IIH were recruited as per a predefined criterion. Magnetic resonance imaging (MRI) brain with detailed sella imaging and pituitary hormonal profile were done in all patients.

    Results:

    Partial empty sella was seen in 55 patients (68.8%). Hormonal abnormalities were detected in 30 patients (37.5%), reduced cortisol levels in 20%, raised prolactin levels in 13.8%, low thyroid-stimulating hormone (TSH) levels in 3.8%, hypogonadism in 1.25%, and elevated levels of gonadotropins were found in 6.25% of participants. Hormonal disturbances were independent and were not associated with the presence of empty sella (p = 0.493).

    Conclusion:

    Hormonal abnormalities were observed in 37.5% patients with IIH. These abnormalities did not correlate with the presence or absence of empty sella. Pituitary dysfunction appears to be subclinical in IIH and responds to intracranial pressure reduction, not requiring specific hormonal therapies.

  • Chapter 11 - Primary and Secondary Amenorrhoea

  • from Section 3 - Reproductive Endocrinology and Infertility
  • Edited by Tahir Mahmood, Charles Savona-Ventura, Ioannis Messinis, Sambit Mukhopadhyay
  • Book:
    The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
    Published online:
    24 November 2021
    Print publication:
    02 December 2021, pp 91-100

  • Summary

    Amenorrhoea is a medical term that is used to describe the absence of menses, which is classified into primary and secondary amenorrhoea. Primary amenorrhoea is encountered in approximately 3% of the population and refers to the concurrent absence of onset of menstruation (menarche), normal growth, secondary sexual characteristics including breast development (thelarche) and growth of pubic hair (adrenarche) when a girl reaches the 13th year of life [1]. The age of menarche varies in the general population; however, it is generally considered that the majority of young girls will experience menarche between the 10th and 16th years of life. Thelarche and adrenarche usually precede the onset of menarche by a period that may vary between a few months and two years. When normal growth is present and secondary sexual development is observed, absence of menstruation is considered normal until the age of 15; however, when this threshold is exceeded primary amenorrhoea is also diagnosed. This threshold is somewhat lower compared to that described in traditional handbooks (16 years of life); however, it is justified by current worldwide trends that seem to suggest a progressive lowering in the age of menarche. In the absence of growth or secondary sexual characteristics, primary amenorrhoea is defined as the absence of menstruation before the age of 14 years.