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Pituitary imaging findings in male patients with hypogonadotrophic hypogonadism

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Abstract

Context

Data on pituitary imaging in adult male patients presenting with hypogonadotrophic hypogonadism (HH) and no known pituitary disease are scarce.

Objective

To assess the usefulness of pituitary imaging in the evaluation of men presenting with HH after excluding known pituitary disorders and hyperprolactinemia.

Design

A historical prospective cohort of males with HH.

Patients

Men who presented for endocrine evaluation from 2011 to 2014 with testosterone levels <10.4 nmol/L (300 ng/mL), normal LH and FSH levels and no known pituitary disease.

Results

Seventy-five men were included in the analysis. Their mean age and BMI were 53.4 ± 14.8 years and 30.7 ± 5.2 kg/m2, respectively. Mean total testosterone, LH, and FSH were 6.2 ± 1.7 nmol/L, 3.4 ± 2 and 4.7 ± 3.1 mIU/L, respectively. Prolactin level within the normal range was obtained in all men (mean 161 ± 61, range 41–347 mIU/L). Sixty-two men had pituitary MRI and 13 performed CT. In 61 (81.3 %) men pituitary imaging was normal. Microadenoma was found in 8 (10.7 %), empty sella and thickened pituitary stalk in one patient (1.3 %) each. In other four patients (5.3 %) a small or mildly asymmetric pituitary gland was noted. No correlation was found between testosterone level and the presence of pituitary anomalies.

Conclusions

This study suggests that the use of routine hypothalamic-pituitary imaging in the evaluation of IHH, in the absence of clinical characteristics of other hormonal loss or sellar compression symptoms, will not increase the diagnostic yield of sellar structural abnormalities over that reported in the general population.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Endocrine Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel

    Dania Hirsch, Carlos Benbassat, Gloria Tsvetov, Ilana Shraga-Slutzky & Ilan Shimon

  2. Maternal Fetal Medicine Division, Rabin Medical Center, Helen Schneider Hospital for Women, Petach Tikva, Israel

    Yoel Toledano

  3. Clalit Health Services, Tel Aviv, Israel

    Irena S’chigol & Yoav Eizenberg

  4. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Dania Hirsch, Carlos Benbassat, Gloria Tsvetov, Ilana Shraga-Slutzky & Ilan Shimon

Authors
  1. Dania Hirsch
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  2. Carlos Benbassat
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  3. Yoel Toledano
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  7. Yoav Eizenberg
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Correspondence to Dania Hirsch.

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Hirsch, D., Benbassat, C., Toledano, Y. et al. Pituitary imaging findings in male patients with hypogonadotrophic hypogonadism. Pituitary 18, 494–499 (2015). https://doi.org/10.1007/s11102-014-0601-x

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  • DOI: https://doi.org/10.1007/s11102-014-0601-x

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