Dynamic MRI in the congenital agenesis of the neural pituitary stalk syndrome: the role of the vascular pituitary stalk in predicting residual anterior pituitary function

The aim of our study was to elucidate the physiological role of the neuropeptide galanin in the regulation of anterior pituitary function in human subjects. Six healthy men (age range 26-35 yr, body mass index range 20-24 kg/m2) underwent in random order 1) an intravenous bolus injection of growth hormone-releasing hormone (GHRH)-(1-29)-NH2 (100 micrograms) + thyrotropin-releasing hormone (TRH, 200 micrograms) + luteinizing hormone-releasing hormone (LHRH, 100 micrograms) + corticotropin-releasing hormone (CRH, 100 micrograms), and 2) intravenous saline (100 ml) at time 0 plus either human galanin (500 micrograms) in saline (100 ml) or saline (100 ml) from -15 to +30 min. Human galanin determined a significant increase in serum GH (GH peak: 11.3 +/- 2.2 micrograms/l) from both baseline and placebo levels. No significant differences were observed between GH values after galanin and those after GHRH alone (24.3 +/- 5.2 micrograms/l). Human galanin significantly enhanced the GH response to GHRH (peak 49.5 +/- 10 micrograms/l) with respect to either GHRH or galanin alone. Human galanin caused a slight decrease in baseline serum adrenocorticotropic hormone (ACTH; 16.3 +/- 2.4 pg/ml) and cortisol levels (8 +/- 1.5 micrograms/dl). Galanin also determined a slight reduction in both the ACTH (peak 27 +/- 8 pg/ml) and cortisol (peak 13.8 +/- 1.3 micrograms/dl) responses to CRH. Baseline and releasing hormone-stimulated secretions of prolactin, thyroid-stimulating hormone, LH, and follicle-stimulating hormone were not altered by galanin. Our data suggest a physiological role for the neuropeptide galanin in the regulation of GH secretion in humans.(ABSTRACT TRUNCATED AT 250 WORDS)

Download Full-text

Regulatory role of galanin in control of hypothalamic-anterior pituitary function.

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.85.24.9861 ◽

1988 ◽

Vol 85 (24) ◽

pp. 9861-9865 ◽

Cited By ~ 73

Author(s):

A. Ottlecz ◽

G. D. Snyder ◽

S. M. McCann

Keyword(s):

Anterior Pituitary ◽

Pituitary Function ◽

Regulatory Role ◽

Anterior Pituitary Function

Download Full-text

Physiological role of the neuropeptide galanin in the regulation of anterior pituitary function in man

Neuropeptides ◽

10.1016/0143-4179(92)90407-n ◽

1992 ◽

Vol 22 (1) ◽

pp. 27

Author(s):

A. Giustina ◽

M. Licini ◽

A.R. Bussi ◽

L. Chiesa

Keyword(s):

Anterior Pituitary ◽

Physiological Role ◽

Pituitary Function ◽

Anterior Pituitary Function

Download Full-text

Diabetes insipidus is an unfavorable prognostic factor for response to glucocorticoids in patients with autoimmune hypophysitis

Acta Endocrinologica ◽

10.1530/eje-17-0123 ◽

2017 ◽

Vol 177 (2) ◽

pp. 127-135 ◽

Cited By ~ 8

Author(s):

Isabella Lupi ◽

Mirco Cosottini ◽

Patrizio Caturegli ◽

Luca Manetti ◽

Claudio Urbani ◽

...

Keyword(s):

Prognostic Factor ◽

Diabetes Insipidus ◽

Anterior Pituitary ◽

Glucocorticoid Therapy ◽

Pituitary Function ◽

Pituitary Stalk ◽

Autoimmune Hypophysitis ◽

Negative Prognostic Factor ◽

Anterior Pituitary Function ◽

Design And Methods

Introduction Autoimmune hypophysitis (AH) has a variable clinical presentation and natural history; likewise, its response to glucocorticoid therapy is often unpredictable. Objective To identify clinical and radiological findings associated with response to glucocorticoids. Design and methods 12 consecutive patients with AH, evaluated from 2008 to 2016. AH was the exclusion diagnosis after ruling out other pituitary masses and secondary causes of hypophysitis. Mean follow-up time was 30 ± 27 months (range 12–96 months). Results MRI identified two main patterns of presentation: global enlargement of the pituitary gland or panhypophysitis (n = 4, PH), and pituitary stalk abnormality only, or infundibulo-neuro-hypophysitis (n = 8, INH). Multiple tropin defects were more common in PH (100%) than those in INH (28% P = 0.014), whereas diabetes insipidus was more common in INH (100%) than that in PH (50%; P = 0.028). All 4 PH and 4 out of 8 INH were treated with glucocorticoids. Pituitary volume significantly reduced in all PH patients (P = 0.012), defective anterior pituitary function recovered only in the two patients without diabetes insipidus (50%) and panhypopituitarism persisted, along with diabetes insipidus, in the remaining 2 (50%). In all INH patients, either treated or untreated, pituitary stalk diameter reduced (P = 0.008) but diabetes insipidus persisted in all. Conclusions Glucocorticoid therapy may improve anterior pituitary function in a subset of patients but has no effect on restoring posterior pituitary function. Diabetes insipidus appears as a negative prognostic factor for response to glucocorticoids.

Download Full-text

Participation of Central Monoamine Neurons in the Regulation of Anterior Pituitary Function with Special Regard to the Neuro-Endocrine Role of Tubero-Infundibular Dopamine Neurons

Aspects of Neuroendocrinology ◽

10.1007/978-3-642-46207-8_20 ◽

1970 ◽

pp. 192-205 ◽

Cited By ~ 18

Author(s):

Kjell Fuxe ◽

Tomas Hökfelt

Keyword(s):

Anterior Pituitary ◽

Dopamine Neurons ◽

Pituitary Function ◽

Special Regard ◽

Monoamine Neurons ◽

Anterior Pituitary Function ◽

Central Monoamine

Download Full-text

Copeptin concentrations increase during glucagon stimulation test: possible role of copeptin in assessment of anterior pituitary function

Endocrine Abstracts ◽

10.1530/endoabs.35.p826 ◽

2014 ◽

Author(s):

Krzysztof Lewandowski ◽

Andrzej Lewinski ◽

Elzbieta Skowronska-Jozwiak ◽

Magdalena Stasiak ◽

Wojciech Horzelski ◽

...

Keyword(s):

Anterior Pituitary ◽

Stimulation Test ◽

Pituitary Function ◽

Glucagon Stimulation Test ◽

Anterior Pituitary Function

Download Full-text

Surgical treatment of craniopharyngiomas. Part II. Endocrine results

Neurosurgical FOCUS ◽

10.3171/foc.1997.3.6.6 ◽

1997 ◽

Vol 3 (6) ◽

pp. E5 ◽

Cited By ~ 3

Author(s):

Jürgen Honegger ◽

Michael Buchfelder ◽

Rudolf Fahlbusch

Keyword(s):

Diabetes Insipidus ◽

Anterior Pituitary ◽

Complete Removal ◽

Complete Recovery ◽

Pituitary Function ◽

Pituitary Stalk ◽

Primary Surgery ◽

Anterior Pituitary Function ◽

Endocrine Axis

This study aimed to elucidate the endocrine outcome of craniopharyngioma surgery. In particular, endocrine results were analyzed in relation to the surgical approach. The study includes 161 patients who underwent pre- and postoperative endocrine assessment, 143 of whom had not previously undergone surgery. Diabetes insipidus was the most common postoperative deficiency in both the transcranial and transsphenoidal groups. In the case of primary surgery (surgery as initial therapy), the overall percentage of patients with diabetes insipidus increased from 16.1% preoperatively to 59.4% postoperatively. After transcranial surgery, the rate of anterior pituitary deficiency also increased. However, normal preoperative anterior pituitary function was maintained in more than 50% of patients for each endocrine axis. Similar results were attained in the group of patients undergoing complete tumor removal. The best result was achieved for gonadal function: the incidence of hypogonadism increased only slightly from 77.4 to 79.8%. During transsphenoidal surgery, anterior pituitary function was generally preserved. An additional deficient axis was encountered postoperatively in only four (11.4%) of 35 primary surgery cases. Endocrine results were not inferior in patients with a ventrally displaced pituitary. This variant required midline incision of the gland for exposure of the craniopharyngioma. Panhypopituitarism was encountered in only one of eight patients in whom the pituitary stalk was partially resected because of tumor infiltration. None of the 88 patients who remained recurrence-free demonstrated endocrine deterioration during follow-up review, compared with the early postoperative assessment 3 months postsurgery. On the other hand, complete recovery of one endocrine axis was observed in nine of these patients during later follow-up evaluations. In five of them, diabetes insipidus had regressed. The authors conclude that it is worth preserving the pituitary stalk and gland at surgery because anterior pituitary function is more often maintained than is generally believed. Postoperative diabetes insipidus must be accepted as a consequence of complete removal of the pituitary. However, pituitary function may recover and diabetes insipidus in particular may abate with time.

Download Full-text