Study of Systemic Disorders Associated with Pituitary Tumors in Damascus Hospital Volume 50- Issue 3

Obaida Ezzat Thuloj¹*, Mohammad Ahmad Alrawashdeh¹ and Taghrid Hammoud^1,2

• ¹Faculty of Medicine, Syrian Private University, Syria
• ²Department of Internal Medicine, Faculty of Medicine, Damascus University, Syria

Received: April 28, 2023;   Published: May 12, 2023

*Corresponding author: Obaida Ezzat Thuloj, faculty of Medicine, Syrian Private University, Syria

DOI: 10.26717/BJSTR.2023.50.007941

Abstract PDF

Background: Pituitary tumors are mostly benign masses and are rarely malignant. Pituitary tumors are either secretory or non-secretory tumors. Pituitary tumors are presented with a variety of symptoms based on the hormone that is secreted.

Methods: A cross-sectional study conducted in Damascus hospital containing 150 patients between the years 2012 and 2022 based on a specific inclusion and exclusion criteria.

Results: Results have shown a correlation between metabolic disorders and being female compared to males. In addition, gastrointestinal symptoms were noticeable in patients with a positive family history.

Conclusion: In this study patients with pituitary tumors presented with a variety of symptoms, which depicts the importance of having more studies done in the future regarding these conditions.

Most pituitary tumors are benign conditions and are rarely malignant. These tumors are divided into secretory and non-secretory tumors based on the tumor’s capability of secreting hormones. A study conducted in the UK showed a prevalence of 77.6 pituitary adenoma cases out of 100000 people. Those were further divided into Prolactinomas (44.6), nonfunctioning PAs (22.2). no correlation was found between age and sex and prevalence and occurrence of pituitary adenomas [1,2]. Clinical presentation of pituitary neoplasms differs based on size and location of the tumor and based whether the adenoma is secreting or non-secreting [3]. Adenomas are classified anatomically or radiologically to Macroadenomas (>1cm) and Microadenomas (<1cm) [3]. Neurological symptoms include headaches, Parinaud’s phenomenon and pituitary ischemia [4]. Adenomas that enlarge may cause compression of the optic chiasm which cause a number of vision impairments such as hemianopia and diplopia [4]. Clinical presentation of secreting adenomas is varied and differs based on the type of the hormone secreted. Prolactinomas cause Galactorrhea and Amenorrhea in females and erectile dysfunction in males. ACTH-secreting tumors causes cushing disease. GH-secreting tumors cause acromegaly (Tables 1-3). Pituitary tumors can be treated either medically, surgically or with radiation therapy based on the signs and symptoms and causations [5,6]. Medication is used in secreting adenomas. Prolactinomas respond to Dopamine agonists and are the first line in treating prolactinomas [7-9].

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Study Population

A cross-sectional study was done in Damascus Hospital. 150 patients were included and all information regarding their demographic data, length of stay. Diagnosis and in- hospital procedures were obtained from the database of the endocrinology department (Tables 4 & 5).

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Statistical Analysis

The data was assembled using MS Excel, and it was then examined using SPSS 20.0. The mean and standard deviation were used as the descriptive statistics for quantitative variables, and frequencies and percentages were used for qualitative data. In order to create hypotheses, relationships between variables were examined using the correlation or unpaired t-test for quantitative data and the Chi-square test for qualitative variables (Table 6).

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Descriptive Analysis

Starting with demographic data of the individuals, two thirds of the sample were females (66%) and the rest were males (34%). Mean age of the studied sample was 42, oldest individual was 74, youngest was 8 and most recurrent age was 50 (Tables 7-9). BMI values of the patients were between 16 and 35. Mean value was 25. Moving on to the habits of the patients, nearly 65% of the patients were non-smokers while the rest of the sample were smokers (35%). Regarding co-morbidities, 56% of the patients did not have accompanying illnesses while the rest had different co-morbidities such as hypertension (21%) and diabetes (15%). As for the surgical history, nearly half of the individuals mentioned that they had no surgical procedure in the past. 16% said that they had pituitary surgery operated on them and 4% had done a caesarian section. Most patients from the sample suffered from neurological symptoms. The most common of these symptoms were vision-related problems (57%) and headaches (50%). Regarding metabolic disorders, 57% percent of patients from a wide variety of metabolic symptoms, 27% of which suffered from morbid obesity and 11% suffered from hyperglycemia (Tables 10-12).

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Relationship Between Variables

Using a P value of >0.05, there was a significant correlation between sex and occurrence of metabolic disturbances, with these disturbances being more common in females (54%) than in males (36%). There was a statistical significance between presence of reproductive system symptoms and sex, as it was more common in females (45%) than in males (15%) with a P value of >0.05. There was an important correlation between the age of the patients and presence of cardiovascular and gastrointestinal symptoms. The mean age of the patients of whom don’t suffer from gastrointestinal symptoms was 42 years while the mean age was 44 years in those who presented with gastrointestinal symptoms (Table 13). Which shows an increased incidence in occurrence of symptoms and being in old ages. Same results were found in patients who presented with cardiovascular symptoms, as the mean age of those individuals was 48 years compared to those who didn’t have cardiovascular symptoms (39 years).

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Pituitary gland tumors grow abnormally in the pituitary gland. Some of those tumors produce too many hormones that control vital body functions [10]. Otherwise, some of pituitary gland tumors produce lower levels of hormones than normal levels that normal pituitary gland dose. Most pituitary tumors are benign adenomas; adenomas remain in situ tissues of the pituitary gland, it does not break out to other parts of the body [1.4]. Adenomas pituitary gland tumors are not similar in term of first symptom arise; yet some of them are discovered by chance of Proceeding MRI or CT for another reason (Tables 14-16). Pituitary tumors that produce hormones can cause a variety of changes and symptoms according to the types of hormones. On the other hand, pituitary tumors that do not produce any hormones mostly present symptomatically in dynamic changes such as pressing on nearby bones that leads to headache and loss of peripheral vision [1]. Besides, pituitary tumors that produce hormones can lead to Nausea and vomiting, weakness, feeling cold, lack or absence of menstruation, Nipple discharge, sexual dysfunction, Low sperm count, hyperglycemia, weight loss, hypertension, joint pain, heart problems, Depression and easily rushing [11]. This study shows a statistical significance between gender types, age and BMI comparing to terms of symptoms [1.5]. Another study that was conducted in the University of Rochester shows that 60% of pituitary tumors can cause visual disturbances, which this study approve [2]. Highly levels of producing growth hormone leads to cartilage destruction. [3.5] Arthritis and joint pain may present as the first symptom of acromegaly, which this study shows in the presence of 16% in total patients [3]. The most common procedure to diagnose the pituitary tumor is CT scan (computerized tomography), but Gadolinium MRI is the best procedure to differentiate between aneurysm and pituitary tumors [3].

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Acknowledgment

We are thankful to the management of the Syrian Private University and for their support in the field of medical training and research. We are thankful to everyone who participated in this study.

Funding

This research received no specific grant from SPU or any other funding agency in the public, commercial or non-profit sectors.

Availability of Data and Materials

All data related to this paper’s conclusion are available and stored by the authors. All data are available from the corresponding author on a reasonable request.

Ethics Approval and Consent to Participate

This study was approved by the Institutional Review Board (IRB) at the Syrian Private University (SPU). All Participants confirmed their written consent by signing the consent form. Participation in the study was voluntary and participants were assured that anyone who was not inclined to participate or decided to withdraw after giving consent would not be victimized. All information collected from this study was kept strictly confidential.

Consent for Publication

Not applicable.