Perioperative hypothalamic pituitary adrenal function in patients with silent corticotroph adenomas

Background Silent corticotroph adenomas (SCAs) are characterized by strong ACTH immunostaining without clinical manifestations of hypercortisolism. Patients with SCAs often present with mechanical symptoms related to tumor growth. This study investigates the hypothalamic pituitary adrenal axis (HPA)...

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Bibliographic Details
Published in:Pituitary 2017-08, Vol.20 (4), p.471-476
Main Authors: Cheres, Abdelle F., ElAsmar, Nadine, Rajpal, Aman, Selman, Warren R., Arafah, Baha M.
Format: Article
Language:English
Subjects:
ACTH-Secreting Pituitary Adenoma - blood
ACTH-Secreting Pituitary Adenoma - physiopathology
Adrenal glands
Adrenocorticotropic hormone
Adrenocorticotropic Hormone - metabolism
Age composition
Cortisol
Dehydroepiandrosterone
Endocrinology
Extubation
Female
Hormones
Human Physiology
Humans
Hypothalamo-Hypophyseal System - drug effects
Hypothalamo-Hypophyseal System - metabolism
Hypothalamus
Hypothalamus - cytology
Hypothalamus - drug effects
Male
Medicine
Medicine & Public Health
Pituitary
Pituitary Diseases - blood
Pituitary Diseases - metabolism
Pituitary Gland - metabolism
Pituitary-Adrenal System - drug effects
Pituitary-Adrenal System - metabolism
Tumors
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Summary:Background Silent corticotroph adenomas (SCAs) are characterized by strong ACTH immunostaining without clinical manifestations of hypercortisolism. Patients with SCAs often present with mechanical symptoms related to tumor growth. This study investigates the hypothalamic pituitary adrenal axis (HPA) characteristics after adenomectomy in patients with SCAs. Methods Biochemical parameters of HPA function were monitored frequently after surgical resection of non-functioning macroadenomas. Levels of ACTH, cortisol, DHEA and DHEA-S were measured frequently for 48 h after adenomectomy. HPA data of patients with SCAs (n = 38) were compared to others (Controls) with non-secreting, ACTH-negative immunostaining adenomas of similar age and gender distribution (n = 182) who had adenomectomy. Result Plasma ACTH increased (P 
ISSN:1386-341X
1573-7403
DOI:10.1007/s11102-017-0809-7