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Clinical presentation, evaluation and case management of primary empty sella syndrome: a retrospective analysis of 10-year single-center patient data
- Source :
- BMC Endocrine Disorders, BMC Endocrine Disorders, Vol 20, Iss 1, Pp 1-11 (2020)
- Publication Year :
- 2020
- Publisher :
- BioMed Central, 2020.
-
Abstract
- Background Primary Empty Sella (PES) syndrome is an increasingly common disorder, mostly diagnosed as an incidental finding during brain imaging scans. We intended to review the clinical management and hormonal profile of patients with PES. Methods The study included ten-year retrospective analysis of registry containing PES cases in the period 2007 to 2017, from a single tertiary care center. The keyword ‘primary empty sella’ was used to retrieve patient details from the radiology unit. The clinical and biochemical profile of PES patients was analyzed. Case management of PES patients and their rate of referral to endocrinologists was explored. Results The registry had 765 cases with a male: female ratio of 1:3.8 suggesting female predominance by almost four times. Although not significant, the onset of disease was earlier for males [Mean ± standard deviation (SD) (46.7 years ±17.3 vs 48.8 years±14.1), p = 0.110]. Almost 79% of the cases were found as an incidental finding during Magnetic Resonance Imaging. Of the total PES cases, only 20% were referred to the endocrinologists and the rest were handled by general physicians. Only 1–2.5% of the cases were evaluated for gonadal, growth and adrenal hormones by the general physicians. The hormonal evaluation by the endocrinologists was also found to be sub-optimal. Headache and visual disturbances were the most common presenting complaints followed by menstrual abnormalities. Endocrine abnormalities like thyroid dysfunction, hyperprolactinemia, hypogonadism and hypocortisolism were highly prevalent among those assessed. Conclusion There is a gross under-evaluation of hormonal assessment and minimal case-referral to Endocrinologists. PES is associated with varying degrees of hormonal dysfunction, and hence early assessment and management is needed. Establishing a standard protocol for diagnosis and case management is essential with the involvement of a multidisciplinary team consisting of endocrinologists, neurologists, primary care phys icians and ophthalmologists.
- Subjects :
- Adult
Male
Pediatrics
medicine.medical_specialty
Time Factors
Referral
Hormone Replacement Therapy
Endocrinology, Diabetes and Metabolism
Saudi Arabia
030209 endocrinology & metabolism
Disease
Single Center
lcsh:Diseases of the endocrine glands. Clinical endocrinology
Empty sella syndrome
Case management
03 medical and health sciences
0302 clinical medicine
Diabetes mellitus
Humans
Medicine
Endocrine system
Retrospective Studies
Empty Sella syndrome
lcsh:RC648-665
medicine.diagnostic_test
business.industry
Hormone assessment
Magnetic resonance imaging
General Medicine
Middle Aged
Prognosis
medicine.disease
Pituitary Hormones
Female
Presentation (obstetrics)
business
human activities
030217 neurology & neurosurgery
Follow-Up Studies
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 14726823
- Volume :
- 20
- Database :
- OpenAIRE
- Journal :
- BMC Endocrine Disorders
- Accession number :
- edsair.doi.dedup.....44e28bc9edec88714494982606d1e6f9