Results of dynamic endocrine testing of hypothalamic pituitary function in patients with a primary "empty" sella syndrome.

A total of 52 patients (38 women, 14 men) with a primary "empty" sella syndrome underwent dynamic endocrine testing consisting of insulin-induced hypoglycaemia and a combined anterior pituitary stimulation test utilizing GnRH and TRH. The diagnosis of an "empty" sella turcica was made on the basis of thin collimation CT reconstructions and in addition either metrizamide cisternography or magnetic resonance (MR) imaging. Only 16 of the patients presented with endocrine problems. Hyperprolactinaemia was the most common endocrine disturbance detected, and was found in 17 individuals. Panhypopituitarism was found in 3 patients. Nine other patients had some degree of partial pituitary insufficiency, but only two of them required replacement therapy. However, 31 patients had no evidence of endocrine dysfunction.