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P.089 Recovery from chronic secondary adrenal insufficiency in patients with pituitary disorders

Published online by Cambridge University Press:  17 June 2016

V Munro
Affiliation:
(Halifax)
B Tugwell
Affiliation:
(Halifax)
S Doucette
Affiliation:
(Halifax)
DB Clarke
Affiliation:
(Halifax)
A Lacroix
Affiliation:
(Montreal)
SA Imran
Affiliation:
(Halifax)
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Abstract

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Background: Patients with pituitary disorders may be placed on steroid replacement for secondary adrenal insufficiency (SAI), generally after pituitary surgery; however, data regarding recovery of long-term SAI are lacking. We conducted a study to assess the longer term recovery rate of SAI in patients with pituitary disorders. Methods: We identified all SAI patients from prospectively entered data in the Halifax Neuropituitary Database from November 1, 2005 to September 30, 2014, who had required glucocorticoid therapy for >3 months, and a minimum follow-up of 6 months. Exclusion: ACTH-secreting adenomas; peri-operative glucocorticoid treatment only; glucocorticoids for non-pituitary conditions. Results: 55 patients fulfilled the criteria, 41 (75%) of which had transsphenoidal surgery. Nine (16.4%) patients had complete recovery of SAI over a median of 20 months (range: 8–51). Smaller tumour size and initial cortisol >175 nmol/L had increased likelihood of recovery; those with secondary hypogonadism or growth hormone deficiency were less likely to recover. Conclusions: This is the first study to examine long-term recover of SAI in patients with pituitary disorders: approximately 1 in 6 patients recover adrenal function, up to 5 years after diagnosis. Consequently, patients with SAI should undergo regular testing to prevent unnecessary chronic glucocorticoid therapy.

Type
Poster Presentations
Copyright
Copyright © The Canadian Journal of Neurological Sciences Inc. 2016