Pituitary apoplexy in pediatric patients: systematic review
DOI:
https://doi.org/10.31053/1853.0605.v79.n2.27984Keywords:
pituitary diseases, pituitary gland, pituitary apoplexy, neurosurgeryAbstract
Introduction: Necrosis or hemorrhage associated with pituitary tumors is an infrequent complication. The term pituitary apoplexy is related to the development of an inflammatory process that leads to meningeal irritation and perielar areas. At the pediatric level, pituitary apoplexy is a very rare pathology and little analyzed in the literature. Methods: We carry out a systematic review of cases published internationally. We performed the analysis of 8 cases published in the literature, 5 cases in the male pediatric population (62.5%), and 3 cases in the female gender (37.5%). Results: The mean age was 12.8 years (SD ± 2.5). The clinical manifestations included: headache, impaired vision, nausea and vomiting, fever, cranial nerve involvement and, to a lesser extent, compromise of the state of consciousness. 75% (n = 6) of the patients had headache, 16.6% had frontal localization, 16.6% had retroorbital pain, and 66.6% did not specify the location. On the other hand, only 37.5% of the patients presented nausea and / or vomiting. While 25% entered with fever and 12.5% (n = 1) they had changes in the state of consciousness. Conclusion: Pituitary apoplexy is a pathology that requires a multidisciplinary approach at the pediatric level, the management directed by neurosurgery and pediatric endocrinology will allow us to offer our patients the best, evidence-based treatment available.
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Zijlker H, Schagen S, Wit JM, Biermasz N, van Furth W, Oostdijk W. Pituitary Adenoma Apoplexy in an Adolescent: A Case Report and Review of the Literature. J Clin Res Pediatr Endocrinol. 2017 Sep 1;9(3):265-273. doi: 10.4274/jcrpe.4420.
Özçetin M, Karacı M, Toroslu E, Edebali N. A pediatric case of pituitary macroadenoma presenting with pituitary apoplexy and cranial nerve involvement: case report. Turk Pediatri Ars. 2016 Sep 1;51(3):162-165. doi: 10.5152/TurkPediatriArs.2016.1945.
Chentli F, Bey A, Belhimer F, Azzoug S. Spontaneous resolution of pituitary apoplexy in a giant boy under 10 years old. J Pediatr Endocrinol Metab. 2012;25(11-12):1177-9. doi: 10.1515/jpem-2012-0256.
Briet C, Salenave S, Bonneville JF, Laws ER, Chanson P. Pituitary Apoplexy. Endocr Rev. 2015 Dec;36(6):622-45. doi: 10.1210/er.2015-1042.
Mehrazin M. Pituitary tumors in children: clinical analysis of 21 cases. Childs Nerv Syst. 2007 Apr;23(4):391-8. doi: 10.1007/s00381-006-0259-4.
Zhang F, Chen J, Lu Y, Ding X. Manifestation, management and outcome of subclinical pituitary adenoma apoplexy. J Clin Neurosci. 2009 Oct;16(10):1273-5. doi: 10.1016/j.jocn.2009.01.003.
Glezer A, Bronstein MD. Pituitary apoplexy: pathophysiology, diagnosis and management. Arch Endocrinol Metab. 2015 Jun;59(3):259-64. doi: 10.1590/2359-3997000000047.
Ostrov SG, Quencer RM, Hoffman JC, Davis PC, Hasso AN, David NJ. Hemorrhage within pituitary adenomas: how often associated with pituitary apoplexy syndrome? AJR Am J Roentgenol. 1989 Jul;153(1):153-60. doi: 10.2214/ajr.153.1.153.
Jankowski PP, Crawford JR, Khanna P, Malicki DM, Ciacci JD, Levy ML. Pituitary tumor apoplexy in adolescents. World Neurosurg. 2015 Apr;83(4):644-51. doi: 10.1016/j.wneu.2014.12.026.
Satyarthee GD, Mahapatra AK. Pituitary apoplexy in a child presenting with massive subarachnoid and intraventricular hemorrhage. J Clin Neurosci. 2005 Jan;12(1):94-6. doi: 10.1016/j.jocn.2003.10.030.
Zijlker H, Schagen S, Wit JM, Biermasz N, van Furth W, Oostdijk W. Pituitary Adenoma Apoplexy in an Adolescent: A Case Report and Review of the Literature. J Clin Res Pediatr Endocrinol. 2017 Sep 1;9(3):265-273. doi: 10.4274/jcrpe.4420.
Yang BP, Yang CW, Mindea SA, Tomita T. Pituitary apoplexy. Pediatr Radiol. 2005 Aug;35(8):830-1. doi: 10.1007/s00247-005-1460-4.
Pinto G, Zerah M, Trivin C, Brauner R. Pituitary apoplexy in an adolescent with prolactin-secreting adenoma. Horm Res. 1998;50(1):38-41. doi: 10.1159/000023199.
Chao CC, Lin CJ. Pituitary apoplexy in a teenager--case report. Pediatr Neurol. 2014 Jun;50(6):648-51. doi: 10.1016/j.pediatrneurol.2014.02.004.
Sugita S, Hirohata M, Tokutomi T, Yamashita M, Shigemori M. A case of pituitary apoplexy in a child. Surg Neurol. 1995 Feb;43(2):154-7. doi: 10.1016/0090-3019(95)80127-3.
Serramito-García R, García-Allut A, Arcos-Algaba AN, Castro-Bouzas D, Santín-Amo JM, Gelabert-González M. Apoplejía pituitaria. Revisión del tema [Pituitary apoplexy. A review]. Neurocirugia (Astur). 2011 Feb;22(1):44-9. Spanish.
Uchiyama H, Nishizawa S, Satoh A, Yokoyama T, Uemura K. Post-traumatic pituitary apoplexy--two case reports. Neurol Med Chir (Tokyo). 1999 Jan;39(1):36-9. doi: 10.2176/nmc.39.36.
Higham CE, Johannsson G, Shalet SM. Hypopituitarism. Lancet. 2016 Nov 12;388(10058):2403-2415. doi: 10.1016/S0140-6736(16)30053-8.
Benza A, Machuca S, Manevy A, Rizzi A, Machuca O, Denis A. Paciente con apoplejía hipofisaria en el Hospital Central del Instituto de Previsión Social. Discover Medicine 2.2 (2019): 59-66.
Hernández A, Velasco D. Apoplejía hipofisaria en posoperatorio inmediato de cirugía cardiaca: a propósito de un caso. Revista Chilena de Anestesia. 2018;47(3):229-235.
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