The reproductive system and gonadotropic function of the pituitary gland in patients with "inactive" pituitary adenoma

The status of the sex system and pituitary gonadotropic function were retrospectively analyzed after diagnosis verification by electron microscopy in 28patients with "inactive"pituitary adenoma, using preoperative serum values of gonadotropins, testosterone, estradiol, and LH and FSH levels from the results of gonadotropin releasing hormone (GnRH). Two variants of the diseases course were distinguished in female (21%) and male (36%) patients with inactive pituitary adenoma involving no clinically manifest endocrine disorders: a) in women: the onset with oligo-opsomenorrhea type disorders of the cycle (57%) associated with the polycystic ovaries syndrome (88%); in men (37%): onset with a decrease of the libido caused by moderate hyperprolactinemia paralleled by an appreciable increase of adenoma with high (mostly FSH) or normal levels of gonadotropins and sex glands unchanged or enlarged; b) clinical and biochemical signs of secondary hypogonadism in women (22%) and men (27%). Two types of LH reactions to GnRH are observed, depending on the state of the sex glands: a) hyperergic reaction with increase of LH reserve in women with polycystic ovaries and in men with normal sex glands; b) hypo- ergic reaction of LH with a decrease of its reserve in the presence of secondary hypogonadism symptoms. A hypoergic reaction of FSH to GnRF and its low pituitary reserve were observed in both groups.

1. Касумова С. Ю. Функциональная морфология аденом гипофиза: Дис. ... д-ра мед. наук. — М., 1985.

2. Козлов Г. И. Реабилитация мужчин с нарушениями половых функций при различной эндокринной патологии: Ав- тореф. дис. ... д-ра мед. наук. — М., 1990.

3. Снигирева Р. Я. Нейроэндокринные нарушения при аденомах гипофиза и их коррекция: Дис. ... д-ра мед. наук. — М., 1987.

4. Тудосе Т. И., Зеленецкая В. С., Козлов Г. И., Пищулин А. А. // Пробл. эндокринол. — 1986. — № 4. — С. 36—39.

5. Asa S. L., Cheng Z. I., Ramyar L. et al. // J. clin. Endocrinol. Metab. - 1992. - Vol. 4, N 5. - P. 1128-1134.

6. Asa S. L., Kovacs K. // Can. J. Neurol. Sci. — 1992. — Vol. 19, N 2. - P. 228-235.

7. Besser G. M., Ross R. J. M. // Recent Advances in Endocrinology and Metabolism. — Edinburgh, 1989. — P. 135—158.

8. Burke С. Ж // Pituitary Adenomas: New Trends in Basic and Clinical Research. — Amsterdam, 1991. — P. 181—192.

9. Croue A., Beldent V., Rousselet M. C. et al. // Hum. Pathol. — 1992 - Vol. 23, N 12. - P. 1332-1339.

10. Faglia G., Spada A., Reck-Peccoz P. et al. // Pituitary Adenomas: New Trends in Basic and Clinical Research. — Amsterdam, 1991. - P. 373-382.

11. Heselfine D., Whife M. C., Kendall-Taylor P. et al. // Clin. Endocrinol. - 1989. - Vol. 31, N 4. - P.411-423.

12. Kwekkeboom D. J., de Jong F. H., Lamberts S. Ж J. // J. clin. Endocrinol. Metab. - 1989. - Vol. 68. - P. 1128.

13. Miura M., Matsukado Y, Kodama T., Mihara Y. // J. Neurosurg. - 1985. - Vol. 62. N 3. - P. 376-382.

14. Yamada S., Asa S. L., Kovacs K. et al. // J. clin. Endocrinol. Metab. - 1989. - Vol. 68, N 1. - P. 73-80.