Title:Inadequate Gonadal Replacement in Patients with Turner Syndrome may Result in Pituitary Volume Enlargement
Volume: 21
Author(s): Gamze Akkus*, Irem Kolsuz, Sinan Sozutok, Bilen Onan, Barıs Karagun, Mehtap Evran, Murat Sert and Tamer Tetiker
Affiliation:
- Faculty of Medicine, Division of Endocrinology, Cukurova University, Adana, Turkey
Keywords:
Turner syndrome, Hypogonadism, Hormone replacement therapy, Pituitary hyperplasia, Estrogen, MRI imaging.
Abstract:
Objectives:
Patients with Turner syndrome need hormone replacement therapy for puberty induction. However, it is not known whether inadequate hormone
replacement therapy affects the pituitary.
Material and Methods:
Patients with Turner syndrome (n=35) and healthy control (n=20) (age/gender matched) subjects were included. MRI imaging of the pituitary was
used to calculate pituitary volumes. According to the estradiol regimen, patients were divided into two groups; (i) those treated with low-dose
conjugated oestrogen (CE, 0.625 mg) and (ii) those treated with combination therapy (ethinyl estradiol+sipropterone acetate; 35 mcg/2 mg).
Pituitary measurements were calculated according to pituitary borders and their distances to each other via pituitary MRI.
Results:
Pituitary hyperplasia (0.58±0.15 cm3vs. 0.40±0.17 cm3) was determined in patients with low dose conjugated estrogen compared to the other
patients or healthy control subjects (0.42±0.16 cm3) (p=0.005). Serum FSH levels of the patients treated with low dose CE were also higher
compared to the patients who received combination therapy (p=0.001).
Conclusion:
Inadequate hormone replacement therapy can cause devastating effects on the bones and uterine health and disrupts the pituitary structure.
