Mortality in patients with pituitary disease.
Sherlock, Mark Ayuk, John Tomlinson, Jeremy W Toogood, Andrew A Aragon-Alonso, Aurora Sheppard, Michael C Bates, Andrew S Stewart, Paul M
Sherlock, Mark
Ayuk, John
Tomlinson, Jeremy W
Toogood, Andrew A
Aragon-Alonso, Aurora
Sheppard, Michael C
Bates, Andrew S
Stewart, Paul M
Advisors
Editors
Other Contributors
Date
2010-06
Date Submitted
Keywords
Other Subjects
Subject Mesh
Acromegaly
Cohort Studies
Craniopharyngioma
Female
Humans
Hypopituitarism
Male
Pituitary ACTH Hypersecretion
Pituitary Diseases
Cohort Studies
Craniopharyngioma
Female
Humans
Hypopituitarism
Male
Pituitary ACTH Hypersecretion
Pituitary Diseases
Planned Date
Start Date
Collaborators
Principal Investigators
Alternative Titles
Publisher
Abstract
Pituitary disease is associated with increased mortality predominantly due to vascular disease. Control of cortisol secretion and GH hypersecretion (and cardiovascular risk factor reduction) is key in the reduction of mortality in patients with Cushing's disease and acromegaly, retrospectively. For patients with acromegaly, the role of IGF-I is less clear-cut. Confounding pituitary hormone deficiencies such as gonadotropins and particularly ACTH deficiency (with higher doses of hydrocortisone replacement) may have a detrimental effect on outcome in patients with pituitary disease. Pituitary radiotherapy is a further factor that has been associated with increased mortality (particularly cerebrovascular). Although standardized mortality ratios in pituitary disease are falling due to improved treatment, mortality for many conditions are still elevated above that of the general population, and therefore further measures are needed. Craniopharyngioma patients have a particularly increased risk of mortality as a result of the tumor itself and treatment to control tumor growth; this is a key area for future research in order to optimize the outcome for these patients.
Language
en
ISSN
1945-7189
eISSN
ISBN
DOI
10.1210/er.2009-0033
PMID
20086217