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Hypogonadism As a Consequence of Craniopharyngioma in Female Patients: Comparison of Childhood and Adult Onset and Effects of Estrogen Replacement Therapy

Overview
Journal Endocrine
Specialty Endocrinology
Date 2024 May 18
PMID 38761348
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Abstract

Purpose: (1) to compare clinical, biochemical features in female patients with hypoestrogenism due to childhood- and adult-onset CP; (2) to reveal effects of estrogen replacement therapy in female patients with childhood-onset CP.

Methods: Thirty-seven women that received specific treatment for CP in the period from 1980 to 2019 were recruited: 21 with childhood-onset and 16 with adult-onset CP. Clinical and hormonal characteristics were evaluated. Seventeen-beta-estradiol 2 mg and dydrogesterone 10 mg in sequential regiment was used in 18 childhood-onset cases. Mean follow-up was 31 months.

Results: Amenorrheic women with childhood- and adult-onset CP presented with the same complaints except for lack of genital hair and breast hypoplasia, which were common in patients with childhood-onset CP. BMI was lower in childhood-onset CP group, as was the proportion of overweight patients. They had more favorable lipid profile. The levels of estradiol, testosterone and DHEA-S were low and did not differ. Uterine and ovary volumes were reduced in all patients, but the decline was noticeable in the childhood-onset group. Mineral bone density of lumbar vertebrae was diminished in childhood-onset group. Estrogen therapy in these patients led to clinical improvement: increase in BMD in lumbar spine without negative changes in BMI and/or lipid profile.

Conclusions: Study showed that women with childhood-onset CP had less negative metabolic changes. However, they have more pronounced breast and uterus hypoplasia and lower BMD in lumbar spine. The estrogen replacement therapy led to clinical improvement and BMD increase in lumbar spine without increase of BMI and/or lipid profile changes.

References
1.
Louis D, Perry A, Wesseling P, Brat D, Cree I, Figarella-Branger D . The 2021 WHO Classification of Tumors of the Central Nervous System: a summary. Neuro Oncol. 2021; 23(8):1231-1251. PMC: 8328013. DOI: 10.1093/neuonc/noab106. View

2.
Diaz M, Kwak S, Root K, Fadil A, Nguyen A, Ladehoff L . Current Approaches to Craniopharyngioma Management. Front Biosci (Landmark Ed). 2023; 27(12):328. DOI: 10.31083/j.fbl2712328. View

3.
Erfurth E . Endocrine aspects and sequel in patients with craniopharyngioma. J Pediatr Endocrinol Metab. 2014; 28(1-2):19-26. DOI: 10.1515/jpem-2014-0419. View

4.
Sterkenburg A, Hoffmann A, Gebhardt U, Warmuth-Metz M, Daubenbuchel A, Muller H . Survival, hypothalamic obesity, and neuropsychological/psychosocial status after childhood-onset craniopharyngioma: newly reported long-term outcomes. Neuro Oncol. 2015; 17(7):1029-38. PMC: 5654354. DOI: 10.1093/neuonc/nov044. View

5.
Ahmed B, Merz C, Johnson B, Bittner V, Berga S, Braunstein G . Diabetes mellitus, hypothalamic hypoestrogenemia, and coronary artery disease in premenopausal women (from the National Heart, Lung, and Blood Institute sponsored WISE study). Am J Cardiol. 2008; 102(2):150-4. PMC: 3615899. DOI: 10.1016/j.amjcard.2008.03.029. View