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Pituitary apoplexy

MedGen UID:
18489
•Concept ID:
C0032001
•
Disease or Syndrome
Synonyms: Apoplexy, Pituitary; Pituitary Apoplexy
SNOMED CT: Pituitary apoplexy (237701005)
Modes of inheritance:
Not genetically inherited
MedGen UID:
988794
•Concept ID:
CN307044
•
Finding
Source: Orphanet
clinical entity without genetic inheritance.
See: This record
Not genetically inherited (Orphanet)
 
Monarch Initiative: MONDO:0006908
Orphanet: ORPHA95613

Definition

A rare pituitary disease characterized by hemorrhagic or non-hemorrhagic necrosis of the pituitary gland. Clinical manifestations typically comprise sudden and severe headache (often with nausea and vomiting), visual disturbances (visual-field defects, loss of visual acuity), oculomotor palsies, and variable degrees of altered consciousness, ranging from lethargy to coma. Acute endocrine dysfunction may also be present, most commonly corticotropic deficiency with severe hypotension and hyponatremia as well as secondary adrenal failure, but also thyrotropic and gonadotropic deficiency. [from ORDO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVPituitary apoplexy
Follow this link to review classifications for Pituitary apoplexy in Orphanet.

Professional guidelines

PubMed

ESE Clinical Practice Guideline on functioning and nonfunctioning pituitary adenomas in pregnancy.
Luger A, Broersen LHA, Biermasz NR, Biller BMK, Buchfelder M, Chanson P, Jorgensen JOL, Kelestimur F, Llahana S, Maiter D, Mintziori G, Petraglia F, Verkauskiene R, Webb SM, Dekkers OM
Eur J Endocrinol 2021 Aug 23;185(3):G1-G33. doi: 10.1530/EJE-21-0462. PMID: 34425558
Management of clinically non-functioning pituitary adenoma.
Chanson P, Raverot G, Castinetti F, Cortet-Rudelli C, Galland F, Salenave S; French Endocrinology Society non-functioning pituitary adenoma work-group
Ann Endocrinol (Paris) 2015 Jul;76(3):239-47. Epub 2015 Jun 10 doi: 10.1016/j.ando.2015.04.002. PMID: 26072284
Pituitary incidentaloma: an endocrine society clinical practice guideline.
Freda PU, Beckers AM, Katznelson L, Molitch ME, Montori VM, Post KD, Vance ML; Endocrine Society
J Clin Endocrinol Metab 2011 Apr;96(4):894-904. doi: 10.1210/jc.2010-1048. PMID: 21474686Free PMC Article

Recent clinical studies

Etiology

COVID-19 and hypopituitarism.
Frara S, Loli P, Allora A, Santini C, di Filippo L, Mortini P, Fleseriu M, Giustina A
Rev Endocr Metab Disord 2022 Apr;23(2):215-231. Epub 2021 Aug 13 doi: 10.1007/s11154-021-09672-y. PMID: 34387832Free PMC Article
COVID-19 and the pituitary.
Frara S, Allora A, Castellino L, di Filippo L, Loli P, Giustina A
Pituitary 2021 Jun;24(3):465-481. Epub 2021 May 3 doi: 10.1007/s11102-021-01148-1. PMID: 33939057Free PMC Article
Pituitary Apoplexy: A Comprehensive Review.
Muthukumar N
Neurol India 2020 May-Jun;68(Supplement):S72-S78. doi: 10.4103/0028-3886.287669. PMID: 32611895
Pituitary Apoplexy.
Briet C, Salenave S, Bonneville JF, Laws ER, Chanson P
Endocr Rev 2015 Dec;36(6):622-45. Epub 2015 Sep 28 doi: 10.1210/er.2015-1042. PMID: 26414232
Management of clinically non-functioning pituitary adenoma.
Chanson P, Raverot G, Castinetti F, Cortet-Rudelli C, Galland F, Salenave S; French Endocrinology Society non-functioning pituitary adenoma work-group
Ann Endocrinol (Paris) 2015 Jul;76(3):239-47. Epub 2015 Jun 10 doi: 10.1016/j.ando.2015.04.002. PMID: 26072284

Diagnosis

Pituitary Apoplexy: Risk Factors and Underlying Molecular Mechanisms.
Biagetti B, Simò R
Int J Mol Sci 2022 Aug 5;23(15) doi: 10.3390/ijms23158721. PMID: 35955859Free PMC Article
Pituitary Apoplexy.
Barkhoudarian G, Kelly DF
Neurosurg Clin N Am 2019 Oct;30(4):457-463. Epub 2019 Aug 7 doi: 10.1016/j.nec.2019.06.001. PMID: 31471052
Endocrine Emergencies With Neurologic Manifestations.
Ishii M
Continuum (Minneap Minn) 2017 Jun;23(3, Neurology of Systemic Disease):778-801. doi: 10.1212/CON.0000000000000467. PMID: 28570329Free PMC Article
Pituitary Apoplexy.
Briet C, Salenave S, Bonneville JF, Laws ER, Chanson P
Endocr Rev 2015 Dec;36(6):622-45. Epub 2015 Sep 28 doi: 10.1210/er.2015-1042. PMID: 26414232
Management of clinically non-functioning pituitary adenoma.
Chanson P, Raverot G, Castinetti F, Cortet-Rudelli C, Galland F, Salenave S; French Endocrinology Society non-functioning pituitary adenoma work-group
Ann Endocrinol (Paris) 2015 Jul;76(3):239-47. Epub 2015 Jun 10 doi: 10.1016/j.ando.2015.04.002. PMID: 26072284

Therapy

Pituitary apoplexy: An emergent and potential life-threatening complication of pituitary adenomas.
Geyik AM, Durmaz MO, Dogan A, Kaya Uğur B, Geyik S, Erkutlu İ, Yasar S, Kırık A, Kose G, Nehir A
Ulus Travma Acil Cerrahi Derg 2022 Apr;28(4):483-489. doi: 10.14744/tjtes.2021.93539. PMID: 35485523Free PMC Article
Insights into non-classic and emerging causes of hypopituitarism.
Prodam F, Caputo M, Mele C, Marzullo P, Aimaretti G
Nat Rev Endocrinol 2021 Feb;17(2):114-129. Epub 2020 Nov 27 doi: 10.1038/s41574-020-00437-2. PMID: 33247226
Pituitary apoplexy.
Wichlińska-Lubińska M, Kozera G
Neurol Neurochir Pol 2019;53(6):413-420. Epub 2019 Nov 20 doi: 10.5603/PJNNS.a2019.0054. PMID: 31745969
Endocrine Emergencies With Neurologic Manifestations.
Ishii M
Continuum (Minneap Minn) 2017 Jun;23(3, Neurology of Systemic Disease):778-801. doi: 10.1212/CON.0000000000000467. PMID: 28570329Free PMC Article
Pituitary Apoplexy.
Briet C, Salenave S, Bonneville JF, Laws ER, Chanson P
Endocr Rev 2015 Dec;36(6):622-45. Epub 2015 Sep 28 doi: 10.1210/er.2015-1042. PMID: 26414232

Prognosis

Covid-19, the thyroid and the pituitary - The real state of play.
Geslot A, Chanson P, Caron P
Ann Endocrinol (Paris) 2022 Apr;83(2):103-108. Epub 2022 Jan 20 doi: 10.1016/j.ando.2021.12.004. PMID: 35065920Free PMC Article
Clinically non-functioning pituitary adenomas.
Chanson P, Wolf P
Presse Med 2021 Dec;50(4):104086. Epub 2021 Oct 28 doi: 10.1016/j.lpm.2021.104086. PMID: 34718111
COVID-19 and the pituitary.
Frara S, Allora A, Castellino L, di Filippo L, Loli P, Giustina A
Pituitary 2021 Jun;24(3):465-481. Epub 2021 May 3 doi: 10.1007/s11102-021-01148-1. PMID: 33939057Free PMC Article
Imaging findings in hypophysitis: a review.
Caranci F, Leone G, Ponsiglione A, Muto M, Tortora F, Muto M, Cirillo S, Brunese L, Cerase A
Radiol Med 2020 Mar;125(3):319-328. Epub 2019 Dec 20 doi: 10.1007/s11547-019-01120-x. PMID: 31863360
Thunderclap headache.
Dilli E
Curr Neurol Neurosci Rep 2014 Apr;14(4):437. doi: 10.1007/s11910-014-0437-9. PMID: 24643327

Clinical prediction guides

Pituitary apoplexy: An emergent and potential life-threatening complication of pituitary adenomas.
Geyik AM, Durmaz MO, Dogan A, Kaya Uğur B, Geyik S, Erkutlu İ, Yasar S, Kırık A, Kose G, Nehir A
Ulus Travma Acil Cerrahi Derg 2022 Apr;28(4):483-489. doi: 10.14744/tjtes.2021.93539. PMID: 35485523Free PMC Article
Covid-19, the thyroid and the pituitary - The real state of play.
Geslot A, Chanson P, Caron P
Ann Endocrinol (Paris) 2022 Apr;83(2):103-108. Epub 2022 Jan 20 doi: 10.1016/j.ando.2021.12.004. PMID: 35065920Free PMC Article
Clinically non-functioning pituitary adenomas.
Chanson P, Wolf P
Presse Med 2021 Dec;50(4):104086. Epub 2021 Oct 28 doi: 10.1016/j.lpm.2021.104086. PMID: 34718111
Imaging findings in hypophysitis: a review.
Caranci F, Leone G, Ponsiglione A, Muto M, Tortora F, Muto M, Cirillo S, Brunese L, Cerase A
Radiol Med 2020 Mar;125(3):319-328. Epub 2019 Dec 20 doi: 10.1007/s11547-019-01120-x. PMID: 31863360
Isolated third, fourth, and sixth cranial nerve palsies from presumed microvascular versus other causes: a prospective study.
Tamhankar MA, Biousse V, Ying GS, Prasad S, Subramanian PS, Lee MS, Eggenberger E, Moss HE, Pineles S, Bennett J, Osborne B, Volpe NJ, Liu GT, Bruce BB, Newman NJ, Galetta SL, Balcer LJ
Ophthalmology 2013 Nov;120(11):2264-9. Epub 2013 Jun 6 doi: 10.1016/j.ophtha.2013.04.009. PMID: 23747163Free PMC Article

Recent systematic reviews

Pituitary Apoplexy Leading to Cerebral Infarction: A Systematic Review.
Jiang Q, Xiao S, Shu L, Huang X, Chen X, Hong H
Eur Neurol 2020;83(2):121-130. Epub 2020 Jun 16 doi: 10.1159/000507190. PMID: 32544913
Surgical versus non-surgical treatment for pituitary apoplexy: A systematic review and meta-analysis.
Tu M, Lu Q, Zhu P, Zheng W
J Neurol Sci 2016 Nov 15;370:258-262. Epub 2016 Sep 23 doi: 10.1016/j.jns.2016.09.047. PMID: 27772771
Headache and pituitary disease: a systematic review.
Kreitschmann-Andermahr I, Siegel S, Weber Carneiro R, Maubach JM, Harbeck B, Brabant G
Clin Endocrinol (Oxf) 2013 Dec;79(6):760-9. Epub 2013 Sep 20 doi: 10.1111/cen.12314. PMID: 23941570
Frequency of pituitary tumor apoplexy during treatment of prolactinomas with dopamine agonists: a systematic review.
Carija R, Vucina D
CNS Neurol Disord Drug Targets 2012 Dec;11(8):1012-4. doi: 10.2174/1871527311211080011. PMID: 23244423
Natural history of nonfunctioning pituitary adenomas and incidentalomas: a systematic review and metaanalysis.
Fernández-Balsells MM, Murad MH, Barwise A, Gallegos-Orozco JF, Paul A, Lane MA, Lampropulos JF, Natividad I, Perestelo-Pérez L, Ponce de León-Lovatón PG, Erwin PJ, Carey J, Montori VM
J Clin Endocrinol Metab 2011 Apr;96(4):905-12. doi: 10.1210/jc.2010-1054. PMID: 21474687

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