Empty sella syndrome - beyond being an incidental finding

Abstract

Introduction: Empty sella is characterized by the herniation of the subarachnoid space within the sella, which is often associated with some degree of flattening of the pituitary gland. This study was undertaken to evaluate the clinical and hormonal profile in patients with empty sella. Aims and Objectives: To evaluate the clinical and hormonal profile of the patients with an empty sella. Materials and Methods: Patients undergoing a CT/MRI at our center, for various reasons but with the finding of the empty sella were included in this study. A detailed history and clinical examination was done. Apart from routine tests, hormonal evaluation included serum thyroid stimulating hormone, T4, cortisol (8 am), prolactin, total testosterone, follicle stimulating hormone, leutinizing hormone, and fasting Insulin like Growth factor 1 (IGF 1) were done. Results: A total of 34 patients, diagnosed radiologically to have empty sella, were evaluated and of them 24 had primary empty sella (PES) and 10 had secondary empty sella (SES). In subjects with PES, 12 out of 24 (50%) had endocrine dysfunction. The most common endocrine dysfunction noted was hyperprolactinemia, which was seen in 5 (20.8%) patients and the most common hormonal deficiency was isolated GH deficiency seen in four patients (12.5%). Conclusion: The high incidence of endocrine abnormalities in patients with PES mandates that these patients should routinely be subjected to endocrine evaluation to detect these deficiencies early, and appropriate replacement instituted where necessary, thus ensuring them of a better quality of life.

Keywords

• Empty sella
• isolated Growth Hormone Deficiency
• Hyperprolactinemia