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Pituitary apoplexy: considerations on a single center experience and review of the literature

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Abstract

Purpose

To present a single-center experience on pituitary tumor apoplexy and a review of literature focusing on predisposing and precipitating factors.

Methods

Clinical presentation of our series of cases. Contemporary published literature is also reviewed.

Results

The definition of this syndrome has not been consistent although now the majority of authors agree to definite it as an acute condition caused by hemorrhage or infarction of a pre-existing pituitary adenoma. Different predisposing and precipitating factors have been described in literature; among these antithrombotic and anticoagulant drugs, seem to play relevant roles. The clinical cases observed in our clinic confirm these data and suggest a probable association between elderly patients taking anticoagulant therapy and pituitary apoplexy adenoma.

Conclusion

Pituitary tumor apoplexy remains a challenging disease in relation to difficulties in correct diagnosis and thus in appropriate treatment. Antithrombotic/anticoagulant therapy may have an important role as precipitating factor. When a pituitary disorder is known, great care should be taken in the prescription of anticoagulant therapy.

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Authors and Affiliations

  1. Unit of Neurosurgery - Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

    L. Giammattei, G. Carrabba, A. Di Cristofori, P. Rampini, M. Minichiello & M. Locatelli

  2. Unit of Endocrinology - Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

    G. Mantovani & E. Verrua

  3. Unit of Pathology - Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

    S. Ferrero

  4. Unit of Otolaringology – Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

    C. Guastella & L. Pignataro

  5. Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy

    S. Ferrero

  6. Department of Pathophysiology and Organ Transplantation, University of Milan, Milan, Italy

    L. Giammattei, A. Di Cristofori & M. Minichiello

  7. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy

    G. Mantovani, E. Verrua, C. Guastella & L. Pignataro

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  1. L. Giammattei
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  2. G. Mantovani
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  3. G. Carrabba
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  11. M. Locatelli
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Correspondence to M. Minichiello.

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Conflict of interest

All the authors of this study have no conflict of interest.

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This study has been approved by the Ethical Committee of IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico. They all have given the permission for the publication of their clinical data.

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All the patients included in this study have signed an informed consent form.

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Giammattei, L., Mantovani, G., Carrabba, G. et al. Pituitary apoplexy: considerations on a single center experience and review of the literature. J Endocrinol Invest 39, 739–746 (2016). https://doi.org/10.1007/s40618-015-0424-2

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  • DOI: https://doi.org/10.1007/s40618-015-0424-2

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