Clinical characteristics of functioning gonadotroph adenoma in women presenting with ovarian hyperstimulation: audit of UK pituitary centres

Papanikolaou, Nikoleta, Millar, Ophelia, Coulden, Amy, Parker, Nina, Sit, Lee, Kelly, Chris, Cox, Jeremy, Dhillo, Waljit, Meeran, Karim, Al Memar, Maya, Anderson, Richard, Rees, Aled ORCID: https://orcid.org/0000-0002-1165-9092, Karavitaki, Niki and Jayasena, Channa 2023. Clinical characteristics of functioning gonadotroph adenoma in women presenting with ovarian hyperstimulation: audit of UK pituitary centres. Clinical Endocrinology 99 (4) , pp. 386-395. 10.1111/cen.14949

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Abstract

Objective Functioning gonadotroph adenomas (FGAs) are rare pituitary tumours stimulating ovarian function with potential life-threatening consequences in women. However, a lack of aggregated clinical experience of FGAs impairs management in affected women. The aim of this study is to present the clinical course of FGA-induced ovarian hyperstimulation syndrome (OHSS) cases as identified by some of the largest UK pituitary endocrine tertiary centres with a view to increasing awareness and improving diagnosis and management of women with FGA. Design A retrospective observational study; audit of eight UK regional pituitary centres for cases of FGAs. Setting Specialist neuroendocrine centres in the United Kingdom. Patients and Measurements Women diagnosed with FGA-induced OHSS. Description of their clinical course. Results Seven cases of FGA were identified in women, all causing OHSS. Mean age was 33.4 years at diagnosis. Abdominal pain, irregular periods, headache, and visual disturbances were reported at presentation by 100%, 71%, 57% and 43% of women, respectively. Three of seven women underwent ovarian surgery before FGA diagnosis. Six women underwent transsphenoidal surgery (TSS) with incomplete tumour resection in five of those, but all showed improvement or resolution in symptoms and biochemistry postoperatively. Conclusion FGA is a rare cause of spontaneous OHSS. TSS improves clinical and biochemical features of ovarian hyperstimulation in FGAs. Improved awareness of FGA will prevent inappropriate emergency ovarian surgery.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG) Medicine Neuroscience and Mental Health Research Institute (NMHRI)
Publisher:	Wiley
ISSN:	0300-0664
Date of First Compliant Deposit:	4 July 2023
Date of Acceptance:	3 July 2023
Last Modified:	27 Feb 2024 12:30
URI:	https://orca.cardiff.ac.uk/id/eprint/160801

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