LONG-TERM CONSEQUENCES OF PARTIALLY TREATED COMBINED PITUITARY HORMONE DEFICIENCY
Keywords:
hypopituitarism, pituitary gland, growth hormone, gonadotropins, prolactin, osteoporosis, dyslipidemia
Abstract
Hypopituitarism refers to the insufficient secretion of one or more pituitary hormones, while the clinical elements are different based on the aetiology, timing of onset, cluster of endocrine dysfunctions, (related or unrelated) co-morbidities as well as applied therapies over the time. We aim to introduce a case of early-onset hypopituitarism with combined deficiency of growth hormone, gonadotropins and prolactin that lead to early diagnosis of osteoporosis and dyslipidaemia as long term complications after she remained without substitution therapy for a long period of time. Of note, the subject associated a non-functioning pituitary micro-tumour that in paediatric population seems to have a different significance than seen in adults (approximately one out of ten adults might have the condition with an accidental detection). In this case, most probably the genetic form of hypopituitarism might be related to the early presence of this lesion. The diagnosis of hypopituitarism should be promptly followed by hormonal substitution of the associated deficiencies, especially if the condition is discovered early in life. This approach is effective for an adequate development and also for avoiding long term complications that can appear later in life such as high risk of low bone mineral density and cardiovascular elements
References
[1] N. Prencipe, L. Marinelli, E. Varaldo, D. Cuboni, A. M. Berton, F. Bioletto, C. Bona, V. Gasco, and S. Grottoli, "Isolated anterior pituitary dysfunction in adulthood," Front Endocrinol (Lausanne), vol. 14, p. 1100007, 2023. doi:10.3389/fendo.2023.
[2] S. Frara, P. Loli, A. Allora, C. Santini, L. di Filippo, P. Mortini, M. Fleseriu, and A. Giustina, "COVID-19 and hypopituitarism," Rev Endocr Metab Disord, vol. 23, no. 2, pp. 215-231, 2022. doi:10.1007/s11154-021-09672-y.
[3] F. Prodam, M. Caputo, C. Mele, P. Marzullo, and G. Aimaretti, "Insights into non-classic and emerging causes of hypopituitarism," Nat Rev Endocrinol, vol. 17, no. 2, pp. 114-129, 2021. doi:10.1038/s41574-020-00437-2.
[4] H. M. Garmes, C. L. Boguszewski, P. A. C. Miranda, M. R. A. Martins, S. R. C. da Silva, J. Z. Filho Abucham, N. R. de Castro Musolino, L. Vilar, L. H. C. Portari, M. R. Gadelha, L. Kasuki, L. A. Naves, M. A. Czepielewski, T. S. de Almeida, F. H. G. Duarte, A. Glezer, and M. D. Bronstein, "Management of hypopituitarism: a perspective from the Brazilian Society of Endocrinology and Metabolism," Arch Endocrinol Metab, vol. 65, no. 2, pp. 212-230, 2021, doi:10.20945/2359-3997000000335.
[5] S. Gray, T. Bilski, B. Dieudonne, and S. Saeed, "Hypopituitarism After Traumatic Brain Injury," Cureus, vol. 11, no. 3, p. e4163, 2019. doi:10.7759/cureus.4163.
[6] M. Popescu, A. Ghemigian, C. M. Vasile, A. Costache, M. Carsote, and A. E. Ghenea, "The new entity of subacute thyroiditis amid the COVID-19 pandemic: from infection to vaccine," Diagnostics (Basel), vol. 12, no. 4, p. 960, 2022, doi:10.3390/diagnostics12040960.
[7] F. Sandru, M. Carsote, R. C. Petca, A. A. Gheorghisan-Galateanu, A. Petca, A. Valea, and M. C. Dumitrascu, "COVID-19-related thyroid conditions (Review)," Exp Ther Med, vol. 22, no. 1, pp. 276, 2021. doi.org/10.3892/etm.2021.10188.
[8] S. Kurtoğlu, A. Özdemir, and N. Hatipoğlu, "Neonatal Hypopituitarism: Approaches to Diagnosis and Treatment," J Clin Res Pediatr Endocrinol, vol. 11, no. 1, pp. 4-12, 2019. doi:10.4274/jcrpe.galenos.2018.2018.0036.
[9] M. Xatzipsalti, A. Voutetakis, L. Stamoyannou, G. P. Chrousos, and C. Kanaka-Gantenbein, "Congenital Hypopituitarism: Various Genes, Various Phenotypes," Horm Metab Res, vol. 51, no. 2, pp. 81-90, 2019. doi:10.1055/a-0822-3637.
[10] P. E. Mullis, "Genetics of growth hormone deficiency," Endocrinol Metab Clin North Am, vol. 36, no. 1, pp. 17-36, 2007. doi:10.1016/j.ecl.2006.11.010.
[11] I. Ara L Bosch, H. Katugampola, and M. T. Dattani, "Congenital Hypopituitarism During the Neonatal Period: Epidemiology, Pathogenesis, Therapeutic Options, and Outcome," Front Pediatr, vol. 8, p. 600962, 2022. doi:10.3389/fped.2020.600962.
[12] H. Bando, S. Urai, K. Kanie, Y. Sasaki, M. Yamamoto, H. Fukuoka, G. Iguchi, and S. A. Camper, "Novel genes and variants associated with congenital pituitary hormone deficiency in the era of next-generation sequencing," Front Endocrinol (Lausanne), vol. 13, p. 1008306, 2022. doi:10.3389/fendo.2022.1008306.
[13] A. Sertedaki, E. B. Tatsi, I. A. Vasilakis, I. Fylaktou, E. Nikaina, N. Iacovidou, T. Siahanidou, and C. Kanaka-Gantenbein, "Whole Exome Sequencing Points towards a Multi-Gene Synergistic Action in the Pathogenesis of Congenital Combined Pituitary Hormone Deficiency," Cells, vol. 11, no. 13, p. 2088, 2022. doi:10.3390/cells11132088.
[14] G. Crisafulli, T. Aversa, G. Zirilli, F. De Luca, R. Gallizzi, and M. Wasniewska, "Congenital hypopituitarism: how to select the patients for genetic analyses," Ital J Pediatr, vol. 44, no. 1, p. 47, 2018. doi:10.1186/s13052-018-0484-y.
[15] A. Ibba and S. Loche, "Diagnosis of GH Deficiency Without GH Stimulation Tests," Front Endocrinol (Lausanne), vol. 13, p. 853290, 2022. doi:10.3389/fendo.2022.853290.
[16] E. Profka, G. Rodari, F. Giacchetti, and C. Giavoli, "GH Deficiency and Replacement Therapy in Hypopituitarism: Insight Into the Relationships With Other Hypothalamic-Pituitary Axes," Front Endocrinol (Lausanne), vol. 12, p. 678778, 2021. doi:10.3389/fendo.2021.678778.
[17] A. Gilis-Januszewska, Ł. Kluczyński, M. Wilusz, J. Pantofliński, R. Turek-Jabrocka, D. Pach, and A. Hubalewska-Dydejczyk, "Pituitary insufficiency following traumatic thoracic injury in an adolescent male patient: A case report and literature review," Medicine (Baltimore), vol. 96, no. 44, p. e8406, 2017. doi:10.1097/MD.0000000000008406.
[18] P. Gergics, "Pituitary Transcription Factor Mutations Leading to Hypopituitarism," Exp Suppl, vol. 111, pp. 263-298, 2019. doi:10.1007/978-3-030-25905-1_13.
[19] J. Smyczyńska, N. Pawelak, M. Hilczer, and A. Lewiński, "Delayed Diagnosis of Congenital Combined Pituitary Hormone Deficiency including Severe Growth Hormone Deficiency in Children with Persistent Neonatal Hypoglycemia-Case Reports and Review," Int J Mol Sci, vol. 23, no. 19, p. 11069, 2022. doi:10.3390/ijms231911069.
[20] J. Argente, K. Tatton-Brown, D. Lehwalder, and R. Pfäffle, "Genetics of Growth Disorders-Which Patients Require Genetic Testing?" Front Endocrinol (Lausanne), vol. 10, p. 602, 2019. doi:10.3389/fendo.2019.00602.
[21] P. Ascoli and F. Cavagnini, "Hypopituitarism," Pituitary, vol. 9, no. 4, pp. 335-342, 2006. doi:10.1007/s11102-006-0416-5.
[22] M. Ahmid, S. F. Ahmed, and M. G. Shaikh, "Childhood-onset growth hormone deficiency and the transition to adulthood: current perspective," Ther Clin Risk Manag, vol. 14, pp. 2283-2291, 2018. doi:10.2147/TCRM.S136576.
[23] G. Mazziotti, A. G. Lania, and E. Canalis, "Skeletal disorders associated with the growth hormone-insulin-like growth factor 1 axis," Nat Rev Endocrinol, vol. 18, no. 6, pp. 353-365, 2022. doi:10.1038/s41574-022-00649-8.
[24] L. Radu, M. Carsote, A. A. Gheorghisan-Galateanu, S. A. Preda, V. Calborean, R. Stanescu, V. Gheorman, and D. M. Albulescu, "Blood Parathyrin and Mineral Metabolism Dynamics. A clinical analyzes," Rev.Chim., vol. 69, no. 10, pp. 2754-2758, 2018.
[25] N. A. Tritos and B. M. K. Biller, "Current concepts of the diagnosis of adult growth hormone deficiency," Rev Endocr Metab Disord, vol. 22, no. 1, pp. 109-116, 2021. doi:10.1007/s11154-020-09594-1.
[26] N. A. Tritos, "Growth hormone deficiency in adults with Cushing's disease," Best Pract Res Clin Endocrinol Metab, vol. 35, no. 2, p. 101474, 2021. doi:10.1016/j.beem.2020.101474.
[27] K. Ikegawa and Y. Hasegawa, "Fracture risk, underlying pathophysiology, and bone quality assessment in patients with Turner syndrome," Front Endocrinol (Lausanne), vol. 13, p. 967857, 2022. doi:10.3389/fendo.2022.967857.
[28] L. T. Wang, L. R. Chen, and K. H. Chen, "Hormone-Related and Drug-Induced Osteoporosis: A Cellular and Molecular Overview," Int J Mol Sci, vol. 24, no. 6, p. 5814, 2023. doi:10.3390/ijms24065814.
[29] V. Russo, R. Chen, and R. Armamento-Villareal, "Hypogonadism, Type-2 Diabetes Mellitus, and Bone Health: A Narrative Review," Front Endocrinol (Lausanne), vol. 11, p. 607240, 2021. doi:10.3389/fendo.2020.607240.
[30] K. I. Alexandraki and A. Grossman, "Management of Hypopituitarism," J Clin Med, vol. 8, no. 12, p. 2153, 2019. doi:10.3390/jcm8122153.
[31] J. Young, C. Xu, G. E. Papadakis, J. S. Acierno, L. Maione, J. Hietamäki, T. Raivio, and N. Pitteloud, "Clinical Management of Congenital Hypogonadotropic Hypogonadism," Endocr Rev, vol. 40, no. 2, pp. 669-710, 2019. doi:10.1210/er.2018-00116.
[32] T. M. Barber, I. Kyrou, G. Kaltsas, A. B. Grossman, H. S. Randeva, and M. O. Weickert, "Mechanisms of Central Hypogonadism," Int J Mol Sci, vol. 22, no. 15, p. 8217, 2021. doi:10.3390/ijms22158217.
[33] J. Young, C. Xu, G. E. Papadakis, J. S. Acierno, L. Maione, J. Hietamäki, T. Raivio, and N. Pitteloud, "Clinical Management of Congenital Hypogonadotropic Hypogonadism," Endocr Rev, vol. 40, no. 2, pp. 669-710, 2019. doi:10.1210/er.2018-00116.
[34] S. S. Amarnath, V. Kumar, and S. L. Das, "Classification of Osteoporosis," Indian J Orthop, vol. 57, suppl. 1, pp. 49-54, Dec. 6, 2023. doi:10.1007/s43465-023-01058-3.
[35] K. Chakrabarti and W. J. McCune, "Glucocorticoid-induced osteoporosis in premenopausal women: management for the rheumatologist," Curr Opin Rheumatol, vol. 35, no. 3, pp. 161-169, 2023. doi:10.1097/BOR.0000000000000934.
[36] M. Carsote, D. N. Paduraru, A. E. Nica, and A. Valea, "Parathyroidectomy: is vitamin D a player for a good outcome?" J Med Life, vol. 9, no. 4, pp. 348-352, 2016.
[37] G. Johannsson and O. Ragnarsson, "Growth hormone deficiency in adults with hypopituitarism-What are the risks and can they be eliminated by therapy?" J Intern Med, vol. 290, no. 6, pp. 1180-1193, 2021. doi:10.1111/joim.13382.
[38] C. C. van Bunderen and D. S. Olsson, "Growth hormone deficiency and replacement therapy in adults: Impact on survival," Rev Endocr Metab Disord, vol. 22, no. 1, pp. 125-133, 2021. doi:10.1007/s11154-020-09599-w.
[39] P. Chanson, "The heart in growth hormone (GH) deficiency and the cardiovascular effects of GH," Ann Endocrinol (Paris), vol. 82, no. 3-4, pp. 210-213, 2021. doi:10.1016/j.ando.2020.03.005.
[40] B. S. Miller, E. Velazquez, and K. C. J. Yuen, "Long-Acting Growth Hormone Preparations - Current Status and Future Considerations," J Clin Endocrinol Metab, vol. 105, no. 6, pp. e2121–33, 2020. doi:10.1210/clinem/dgz149.
[41] P. F. Collett-Solberg, G. Ambler, P. F. Backeljauw, M. Bidlingmaier, B. M. K. Biller, M. C. S. Boguszewski, P. T. Cheung, C. S. Y. Choong, L. E. Cohen, P. Cohen, A. Dauber, C. L. Deal, C. Gong, Y. Hasegawa, A. R. Hoffman, P. L. Hofman, R. Horikawa, A. A. L. Jorge, A. Juul, P. Kamenický, V. Khadilkar, J. J. Kopchick, B. Kriström, M. L. A. Lopes, X. Luo, B. S. Miller, M. Misra, I. Netchine, S. Radovick, M. B. Ranke, A. D. Rogol, R. G. Rosenfeld, P. Saenger, J. M. Wit, and J. Woelfle, "Diagnosis, Genetics, and Therapy of Short Stature in Children: A Growth Hormone Research Society International Perspective," Horm Res Paediatr., vol. 92, no. 1, pp. 1-14, 2019, doi: 10.1159/000502231.
[42] B. S. Miller and K. C. J. Yuen, "Spotlight on Lonapegsomatropin Once-Weekly Injection and Its Potential in the Treatment of Growth Hormone Deficiency in Pediatric Patients," Drug Des Devel Ther, vol. 16, pp. 2055-2066, 2022. doi:10.2147/DDDT.S336285.
[43] V. Pampanini, A. Deodati, E. Inzaghi, and S. Cianfarani, "Long-acting growth hormone preparations and their use in children with growth hormone deficiency," Horm Res Paediatr, 2022. doi:10.1159/000523791.
[44] P. Souteiro, R. Maia, R. Santos-Silva, R. Figueiredo, C. Costa, S. Belo, C. Castro-Correia, D. Carvalho, and M. Fontoura, "Pituitary incidentalomas in paediatric age are different from those described in adulthood," Pituitary, vol. 22, no. 2, pp. 124-128, 2019. doi:10.1007/s11102-019-00940-4.
[45] M. Shareef, M. P. Nasrallah, N. AlArab, L. A. Atweh, C. Zadeh, and R. Hourani, "Pituitary incidentalomas in paediatric population: Incidence and characteristics," Clin Endocrinol (Oxf), vol. 94, no. 2, pp. 269-276, 2021. doi:10.1111/cen.14353.
[2] S. Frara, P. Loli, A. Allora, C. Santini, L. di Filippo, P. Mortini, M. Fleseriu, and A. Giustina, "COVID-19 and hypopituitarism," Rev Endocr Metab Disord, vol. 23, no. 2, pp. 215-231, 2022. doi:10.1007/s11154-021-09672-y.
[3] F. Prodam, M. Caputo, C. Mele, P. Marzullo, and G. Aimaretti, "Insights into non-classic and emerging causes of hypopituitarism," Nat Rev Endocrinol, vol. 17, no. 2, pp. 114-129, 2021. doi:10.1038/s41574-020-00437-2.
[4] H. M. Garmes, C. L. Boguszewski, P. A. C. Miranda, M. R. A. Martins, S. R. C. da Silva, J. Z. Filho Abucham, N. R. de Castro Musolino, L. Vilar, L. H. C. Portari, M. R. Gadelha, L. Kasuki, L. A. Naves, M. A. Czepielewski, T. S. de Almeida, F. H. G. Duarte, A. Glezer, and M. D. Bronstein, "Management of hypopituitarism: a perspective from the Brazilian Society of Endocrinology and Metabolism," Arch Endocrinol Metab, vol. 65, no. 2, pp. 212-230, 2021, doi:10.20945/2359-3997000000335.
[5] S. Gray, T. Bilski, B. Dieudonne, and S. Saeed, "Hypopituitarism After Traumatic Brain Injury," Cureus, vol. 11, no. 3, p. e4163, 2019. doi:10.7759/cureus.4163.
[6] M. Popescu, A. Ghemigian, C. M. Vasile, A. Costache, M. Carsote, and A. E. Ghenea, "The new entity of subacute thyroiditis amid the COVID-19 pandemic: from infection to vaccine," Diagnostics (Basel), vol. 12, no. 4, p. 960, 2022, doi:10.3390/diagnostics12040960.
[7] F. Sandru, M. Carsote, R. C. Petca, A. A. Gheorghisan-Galateanu, A. Petca, A. Valea, and M. C. Dumitrascu, "COVID-19-related thyroid conditions (Review)," Exp Ther Med, vol. 22, no. 1, pp. 276, 2021. doi.org/10.3892/etm.2021.10188.
[8] S. Kurtoğlu, A. Özdemir, and N. Hatipoğlu, "Neonatal Hypopituitarism: Approaches to Diagnosis and Treatment," J Clin Res Pediatr Endocrinol, vol. 11, no. 1, pp. 4-12, 2019. doi:10.4274/jcrpe.galenos.2018.2018.0036.
[9] M. Xatzipsalti, A. Voutetakis, L. Stamoyannou, G. P. Chrousos, and C. Kanaka-Gantenbein, "Congenital Hypopituitarism: Various Genes, Various Phenotypes," Horm Metab Res, vol. 51, no. 2, pp. 81-90, 2019. doi:10.1055/a-0822-3637.
[10] P. E. Mullis, "Genetics of growth hormone deficiency," Endocrinol Metab Clin North Am, vol. 36, no. 1, pp. 17-36, 2007. doi:10.1016/j.ecl.2006.11.010.
[11] I. Ara L Bosch, H. Katugampola, and M. T. Dattani, "Congenital Hypopituitarism During the Neonatal Period: Epidemiology, Pathogenesis, Therapeutic Options, and Outcome," Front Pediatr, vol. 8, p. 600962, 2022. doi:10.3389/fped.2020.600962.
[12] H. Bando, S. Urai, K. Kanie, Y. Sasaki, M. Yamamoto, H. Fukuoka, G. Iguchi, and S. A. Camper, "Novel genes and variants associated with congenital pituitary hormone deficiency in the era of next-generation sequencing," Front Endocrinol (Lausanne), vol. 13, p. 1008306, 2022. doi:10.3389/fendo.2022.1008306.
[13] A. Sertedaki, E. B. Tatsi, I. A. Vasilakis, I. Fylaktou, E. Nikaina, N. Iacovidou, T. Siahanidou, and C. Kanaka-Gantenbein, "Whole Exome Sequencing Points towards a Multi-Gene Synergistic Action in the Pathogenesis of Congenital Combined Pituitary Hormone Deficiency," Cells, vol. 11, no. 13, p. 2088, 2022. doi:10.3390/cells11132088.
[14] G. Crisafulli, T. Aversa, G. Zirilli, F. De Luca, R. Gallizzi, and M. Wasniewska, "Congenital hypopituitarism: how to select the patients for genetic analyses," Ital J Pediatr, vol. 44, no. 1, p. 47, 2018. doi:10.1186/s13052-018-0484-y.
[15] A. Ibba and S. Loche, "Diagnosis of GH Deficiency Without GH Stimulation Tests," Front Endocrinol (Lausanne), vol. 13, p. 853290, 2022. doi:10.3389/fendo.2022.853290.
[16] E. Profka, G. Rodari, F. Giacchetti, and C. Giavoli, "GH Deficiency and Replacement Therapy in Hypopituitarism: Insight Into the Relationships With Other Hypothalamic-Pituitary Axes," Front Endocrinol (Lausanne), vol. 12, p. 678778, 2021. doi:10.3389/fendo.2021.678778.
[17] A. Gilis-Januszewska, Ł. Kluczyński, M. Wilusz, J. Pantofliński, R. Turek-Jabrocka, D. Pach, and A. Hubalewska-Dydejczyk, "Pituitary insufficiency following traumatic thoracic injury in an adolescent male patient: A case report and literature review," Medicine (Baltimore), vol. 96, no. 44, p. e8406, 2017. doi:10.1097/MD.0000000000008406.
[18] P. Gergics, "Pituitary Transcription Factor Mutations Leading to Hypopituitarism," Exp Suppl, vol. 111, pp. 263-298, 2019. doi:10.1007/978-3-030-25905-1_13.
[19] J. Smyczyńska, N. Pawelak, M. Hilczer, and A. Lewiński, "Delayed Diagnosis of Congenital Combined Pituitary Hormone Deficiency including Severe Growth Hormone Deficiency in Children with Persistent Neonatal Hypoglycemia-Case Reports and Review," Int J Mol Sci, vol. 23, no. 19, p. 11069, 2022. doi:10.3390/ijms231911069.
[20] J. Argente, K. Tatton-Brown, D. Lehwalder, and R. Pfäffle, "Genetics of Growth Disorders-Which Patients Require Genetic Testing?" Front Endocrinol (Lausanne), vol. 10, p. 602, 2019. doi:10.3389/fendo.2019.00602.
[21] P. Ascoli and F. Cavagnini, "Hypopituitarism," Pituitary, vol. 9, no. 4, pp. 335-342, 2006. doi:10.1007/s11102-006-0416-5.
[22] M. Ahmid, S. F. Ahmed, and M. G. Shaikh, "Childhood-onset growth hormone deficiency and the transition to adulthood: current perspective," Ther Clin Risk Manag, vol. 14, pp. 2283-2291, 2018. doi:10.2147/TCRM.S136576.
[23] G. Mazziotti, A. G. Lania, and E. Canalis, "Skeletal disorders associated with the growth hormone-insulin-like growth factor 1 axis," Nat Rev Endocrinol, vol. 18, no. 6, pp. 353-365, 2022. doi:10.1038/s41574-022-00649-8.
[24] L. Radu, M. Carsote, A. A. Gheorghisan-Galateanu, S. A. Preda, V. Calborean, R. Stanescu, V. Gheorman, and D. M. Albulescu, "Blood Parathyrin and Mineral Metabolism Dynamics. A clinical analyzes," Rev.Chim., vol. 69, no. 10, pp. 2754-2758, 2018.
[25] N. A. Tritos and B. M. K. Biller, "Current concepts of the diagnosis of adult growth hormone deficiency," Rev Endocr Metab Disord, vol. 22, no. 1, pp. 109-116, 2021. doi:10.1007/s11154-020-09594-1.
[26] N. A. Tritos, "Growth hormone deficiency in adults with Cushing's disease," Best Pract Res Clin Endocrinol Metab, vol. 35, no. 2, p. 101474, 2021. doi:10.1016/j.beem.2020.101474.
[27] K. Ikegawa and Y. Hasegawa, "Fracture risk, underlying pathophysiology, and bone quality assessment in patients with Turner syndrome," Front Endocrinol (Lausanne), vol. 13, p. 967857, 2022. doi:10.3389/fendo.2022.967857.
[28] L. T. Wang, L. R. Chen, and K. H. Chen, "Hormone-Related and Drug-Induced Osteoporosis: A Cellular and Molecular Overview," Int J Mol Sci, vol. 24, no. 6, p. 5814, 2023. doi:10.3390/ijms24065814.
[29] V. Russo, R. Chen, and R. Armamento-Villareal, "Hypogonadism, Type-2 Diabetes Mellitus, and Bone Health: A Narrative Review," Front Endocrinol (Lausanne), vol. 11, p. 607240, 2021. doi:10.3389/fendo.2020.607240.
[30] K. I. Alexandraki and A. Grossman, "Management of Hypopituitarism," J Clin Med, vol. 8, no. 12, p. 2153, 2019. doi:10.3390/jcm8122153.
[31] J. Young, C. Xu, G. E. Papadakis, J. S. Acierno, L. Maione, J. Hietamäki, T. Raivio, and N. Pitteloud, "Clinical Management of Congenital Hypogonadotropic Hypogonadism," Endocr Rev, vol. 40, no. 2, pp. 669-710, 2019. doi:10.1210/er.2018-00116.
[32] T. M. Barber, I. Kyrou, G. Kaltsas, A. B. Grossman, H. S. Randeva, and M. O. Weickert, "Mechanisms of Central Hypogonadism," Int J Mol Sci, vol. 22, no. 15, p. 8217, 2021. doi:10.3390/ijms22158217.
[33] J. Young, C. Xu, G. E. Papadakis, J. S. Acierno, L. Maione, J. Hietamäki, T. Raivio, and N. Pitteloud, "Clinical Management of Congenital Hypogonadotropic Hypogonadism," Endocr Rev, vol. 40, no. 2, pp. 669-710, 2019. doi:10.1210/er.2018-00116.
[34] S. S. Amarnath, V. Kumar, and S. L. Das, "Classification of Osteoporosis," Indian J Orthop, vol. 57, suppl. 1, pp. 49-54, Dec. 6, 2023. doi:10.1007/s43465-023-01058-3.
[35] K. Chakrabarti and W. J. McCune, "Glucocorticoid-induced osteoporosis in premenopausal women: management for the rheumatologist," Curr Opin Rheumatol, vol. 35, no. 3, pp. 161-169, 2023. doi:10.1097/BOR.0000000000000934.
[36] M. Carsote, D. N. Paduraru, A. E. Nica, and A. Valea, "Parathyroidectomy: is vitamin D a player for a good outcome?" J Med Life, vol. 9, no. 4, pp. 348-352, 2016.
[37] G. Johannsson and O. Ragnarsson, "Growth hormone deficiency in adults with hypopituitarism-What are the risks and can they be eliminated by therapy?" J Intern Med, vol. 290, no. 6, pp. 1180-1193, 2021. doi:10.1111/joim.13382.
[38] C. C. van Bunderen and D. S. Olsson, "Growth hormone deficiency and replacement therapy in adults: Impact on survival," Rev Endocr Metab Disord, vol. 22, no. 1, pp. 125-133, 2021. doi:10.1007/s11154-020-09599-w.
[39] P. Chanson, "The heart in growth hormone (GH) deficiency and the cardiovascular effects of GH," Ann Endocrinol (Paris), vol. 82, no. 3-4, pp. 210-213, 2021. doi:10.1016/j.ando.2020.03.005.
[40] B. S. Miller, E. Velazquez, and K. C. J. Yuen, "Long-Acting Growth Hormone Preparations - Current Status and Future Considerations," J Clin Endocrinol Metab, vol. 105, no. 6, pp. e2121–33, 2020. doi:10.1210/clinem/dgz149.
[41] P. F. Collett-Solberg, G. Ambler, P. F. Backeljauw, M. Bidlingmaier, B. M. K. Biller, M. C. S. Boguszewski, P. T. Cheung, C. S. Y. Choong, L. E. Cohen, P. Cohen, A. Dauber, C. L. Deal, C. Gong, Y. Hasegawa, A. R. Hoffman, P. L. Hofman, R. Horikawa, A. A. L. Jorge, A. Juul, P. Kamenický, V. Khadilkar, J. J. Kopchick, B. Kriström, M. L. A. Lopes, X. Luo, B. S. Miller, M. Misra, I. Netchine, S. Radovick, M. B. Ranke, A. D. Rogol, R. G. Rosenfeld, P. Saenger, J. M. Wit, and J. Woelfle, "Diagnosis, Genetics, and Therapy of Short Stature in Children: A Growth Hormone Research Society International Perspective," Horm Res Paediatr., vol. 92, no. 1, pp. 1-14, 2019, doi: 10.1159/000502231.
[42] B. S. Miller and K. C. J. Yuen, "Spotlight on Lonapegsomatropin Once-Weekly Injection and Its Potential in the Treatment of Growth Hormone Deficiency in Pediatric Patients," Drug Des Devel Ther, vol. 16, pp. 2055-2066, 2022. doi:10.2147/DDDT.S336285.
[43] V. Pampanini, A. Deodati, E. Inzaghi, and S. Cianfarani, "Long-acting growth hormone preparations and their use in children with growth hormone deficiency," Horm Res Paediatr, 2022. doi:10.1159/000523791.
[44] P. Souteiro, R. Maia, R. Santos-Silva, R. Figueiredo, C. Costa, S. Belo, C. Castro-Correia, D. Carvalho, and M. Fontoura, "Pituitary incidentalomas in paediatric age are different from those described in adulthood," Pituitary, vol. 22, no. 2, pp. 124-128, 2019. doi:10.1007/s11102-019-00940-4.
[45] M. Shareef, M. P. Nasrallah, N. AlArab, L. A. Atweh, C. Zadeh, and R. Hourani, "Pituitary incidentalomas in paediatric population: Incidence and characteristics," Clin Endocrinol (Oxf), vol. 94, no. 2, pp. 269-276, 2021. doi:10.1111/cen.14353.
Published
2024-01-21
How to Cite
Sima, O., Trandafir, A., Gheorghe, A., Petrova, E., Ghemigian, A., Șandru, F., Stanciu, M., & Carșote, M. (2024). LONG-TERM CONSEQUENCES OF PARTIALLY TREATED COMBINED PITUITARY HORMONE DEFICIENCY. Romanian Journal of Clinical Research, 6(2). https://doi.org/10.33695/rjcr.v6i2.209
Section
Articles
