Work

NE08 Clinical presentation and long-term pituitary function after apoplexy: a single-center experience

Year: 2026

Type: conference-abstract

Abstract: Background Pituitary apoplexy is a rare endocrine emergency with heterogeneous neurological, ophthalmological and endocrine manifestations. Although acute neuro-ophthalmological compromise often determines immediate management, endocrine dysfunction may persist after the acute event. Purpose To evaluate clinical presentation, management and long-term endocrine outcomes in patients with pituitary apoplexy. Methods We retrospectively reviewed 25 patients identified from medical records between 2015 and 2026 at the Department of Neuroendocrinology, University Clinical Centre of Serbia. Inclusion required documented pituitary apoplexy supported by compatible clinical and/or radiological, operative or histopathological findings. Continuous variables were summarized as median and range, categorical variables as counts and percentages, and management groups were compared using the two-sided Fisher’s exact test. Missing data were not imputed. Results The cohort included 14 men and 11 women. Tumours comprised 15 non-functioning adenomas, 8 prolactinomas, one mixed GH/PRL adenoma and one tumour of uncertain type. Headache occurred in 19/25 patients, visual disturbances in 18/25, and diplopia/ophthalmoplegia in 12/25. Secondary adrenal insufficiency was documented in 20/25 patients, acute glucocorticoid treatment in 21/23, hypopituitarism at presentation in 21/24, and hyponatraemia in 7/22. Ten patients underwent surgery and 15 were managed conservatively or medically. Diplopia/ophthalmoplegia was more frequent in surgically managed patients (8/10 vs 4/15; p=0.015). During a median 42-month follow-up, persistent hypopituitarism was documented in 18/23 patients; diabetes insipidus occurred in 4/25, all surgically managed. Conclusion Pituitary apoplexy carries substantial acute and long-term endocrine morbidity. Persistent pituitary dysfunction remained common irrespective of initial management, supporting early adrenal assessment, timely glucocorticoid treatment and long-term follow-up.

Source: European Journal of Endocrinology

DOI: 10.1093/ejendo/lvag128.053